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Full text of "The New Jersey medical reporter"

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THE 



NEW JERSEY 



MEDICAL REPORTER, 



AND 



TRANSACTIONS 



OP THE 



IEW JERSEY MEDICAL SOCIETY. 



EDITED BY S. W. BUTLER, M. D. 



AND 



JOSEPH PARRISH, M. D. 




BURLINGTON : 

PUBLISHED BY S. W. BUTLER, M.I>. 

1854. 
















JOHN RODQERS, PRINTER, 



BURLINGTON, N, J. 






INDEX. 



Academy of Medicine, Paris, 70. 
Acid, a peculiar, secreted in the lungs, 253 
Albuminuria, &c, 350. 
Alcohol, use ol, in Medicine, 237. 
Aneurism treated by injections of Per chlo- 
ride of Iron, 70. 
Animal heat, new theory of, 445. 
Army Medical Board, 120. 
Asiatic Cnolera, 375, 380. 
American Medical Association, 44,78, 118. 
203 234 265. 
History of,' 26, 42, 175, 245, 341, 501. 
Proceedings of Seventh Annual Meet- 
ing, 273. 
List of Delegates, 275. 
Officers for 1854-5, 285. 
Standing Committees, 294. 

Beverages, use of in Sickness, 531. 
Biography — 

Jonathan Knight, M. D„ 34. 

W. E.Horner, M.D., 103. 

A. H. Stevens, M. D., 262. 

H. S. Patterson, M. D., 267. 

John C. Warren, M. D.. 360. 

John A. Swett, M. D., 441. 

W. F. Combs, M.D., 441, 

J. L. Day, M. D., 441. 

R. D. Mussey, M.D., 510. 

John P, Heister, M. D., 519. 

Wm, Turk, M. D., U. S. N., 530. 
Bibliographical Notices — 

Condie — Diseases of Children, 37. 

Hunter and Ricord — Venereal Dis 
ease, 37. 

Ellis — Medical Formulary, 38. 

Simpson — Homoeopathy, 106. 

Flint— Dysentery, 110. 
" on Chronic Pleurisy, HO. 1 

Buckler — FibroBronchitis and Rheu 
matic Pneumonia, 113. 

Carpenter — use and abuse of Alcoho- 
lic Liquors, 114. 

Fownes — Elementary Chemistry, 114 

Works in Press — 115. 

VOL. VII. — 69 



Bibliographical Notices — 

Pereira — Materia Medica and Thera- 
peutics, 194. 

Meigs— Diseases ofNeck of Uterus,196. 

LaRoche— Pneumonia, 198. 

Henderson — Homoeopathy, 199. 

A. Vidal (de Cassis) Venereal Dis- 
eases, 200. 

Transactions of State Medical Socie- 
ties, 215, 368. 

Nott & Gliddon — Types of Mankind, 
222. 

Warren — The Preservation of Health, 
223. 

Fuller — Rheumatism, &c, 224. 

Richardson — Elements of Human An- 
atomy, 225. 

Bennett — Inflammation of the Uterus, 
fee, 226. 

West — Diseases of Infancy and Child- 
hood, 226. 

Meigs — Woman, her diseases and re- 
medies, 325, 

Erichsen — Science and Art of Surge- 
ry, 327. 

Abel & Bloxham — Hand-book of Che- 
mistry. 408. 

Griffith — Universal Formulary, 409, 

Thompson— Pulmonary Consumption, 
410, 

Hughes — On Auscultation, 411. 

Bennett-Pulmonary Tuberculosis,41 1, 

Parker — Syphilitic diseases, 413. 

Earle — Institutions for the Insane, 430. 
" Bloodletting in mental disorders, 
430. 

Howe — Training and Teaching Idiots, 
430. 

Gait — Asylums for persons of unsound 
mind, 430. 

Wilson— Healthy Skin, 476. 

Burnham — Principles of Animal and 
Vegetable Physiology, 476. 

Skoda-^— Auscultation and Percussion, 
477. 



INDEX. 



Bibliographical Notices — 

Owen — Skeleton and Teeth, 478. 

Kolliker — Human Microscopical Ana- 
tomy, 478. 

Physician's Visiting List, 482. 

Drake — Diseases of the Interior Valley 
ofN. A., 525, 

Bernard — Lectures on the Blood, 526, 

Cataract, operation of Extraction tor the re 

moval of. 17. 
"Change of Life" in Women, 13, 63, 92, 

205, 313, 381. 
Children, Mortality among, 488. 
China, Practice of Medicine in, 337. 
Chinese Pharmacy, remarks on, 338. 
Chloroform ointment, 418, 
Chlorosis, Salts of Manganese in, 418, 
Cholera, Asiatic, 375, 539. 
Cholera Morbus, Treatment of, 443. 
Circular of Stan, Com. of N. Jersey, 233, 
Correspondence, 22, 66, 97, 98. 
Croup, Membranous, Nitrate of Silver in 

428. 
Cynanche Trachealis, 301. 

Deaths from Ignorance, 537. 
Delirium Tremens — Periodical exacerba- 
tions, 391, 
Treatment of, 449. 
Doctor's Commons, 49. 
Drunkenness, Plea of, 184. 

Editorial — 

Our Seventh Volume, 40. 

Scheidam Schnapps, 41. 

Epidemic Cholera, 42. 

Am. Med. Association, 44, 203, 265. 

Apologetic, 44. 

Change in Editorship— Removal, 74. 

Salutatory, 75. 

Astor Library, 76. 

Subcutaneous Vaccination, 77. 

State Medical Society, 77. 

Bibliographical Department, 77. 

Our Foreign Correspondence, 78. 

Med. Soc. of New Jersey, 116. 

Correspondence, 117. 

An American Medical Review, 201 

Old Physic and Young Pharmacy, 227 

Private Practical Instruction, 230. 

" Black Lists," 232. 

A capital suggestion, 266. 

District Medical Societies, 266, 

The late H. S. Patterson, M. D., 267. 

About our&elves, 272. 

Change in the Medical Law, 329, 

Welch's Splints, 332, 

Medical Society of N. J., 374. 

Asiatic Cholera, 375. 

Private Medical Institutions, 376. 



Editorial — 

Depository of Medical Literature, 377. 

Philadelphia and her Medical Schools, 
414. 

Professor Gibson, 415. 

Encouragement, 415. 

Hydrangea Arborescens, 416. 

New York and her Medical Schools, 
436. 

Further enlargement, &c, 438. 

Blockley Hospital, Philadelphia, 439. 

Physicians or Politicians ? Office of Co- 
roner, 479, 

An invitation, 480. 

Ethnology, 481. 

Close of Volume vii., 527. 

Mortality the past year, 529. 

Our late colleague, Dr. Parrisfy 530. 

Editor's Table— 

Lecture by J. Knight, M. D.,— intro- 
ductory, &c, 78. 
Vermont Asylum for the Insane, 79. 
Montreal Medical Chronicle, &c, 79-. 
Treatment of Vesico- Vaginal Fistula, 

79. 
American Medical Monthly, 118. 
Western Journ of Med. and Surg., 1 18. 
Norton's Literary Register, 118. 
Legitimate goal of professional ambi- 
tion, 118. 
The People's Gazette, 235. 
Priority in medication of Larynx and 

Trachea, 235. 
Annals of Scienee, 236. 
History of Yellow fever in N, Orleans, 

236. 
Georgia "Blister and Critic," 440. 
Elderberries, Syrup of, 446. 
Erigeron Canadense, volatile oil of, 499. 
Erysipelas, Gangrenous, 89. 
Exostosis of Orbit— remarkable operation 
tor, 418. 

Fever, Intermittent, treated by Chloride of 
Sodium, 256. 
" Quinia and tartaric acid in, 334. 

Gleet, treatment of, 420. 



Hemorrhage, Post Partum, 5. 
Hemorrhage, Secale Cornutum in, 336. 
Hints for Young Doctors, 334. 
Human Races, Cranial Characteristics and 

powers of, 483. 
Hydrangea Arborescens, 416, 426. 
Hydrangea Arborescens in Irritation of 

Bladder, 393. 
Hysterical Mononiaaia, 58. 



INDEX. 



543 



Imaginary Diseases, 307. 

Incompatibles, taMe of, 336. 

Indigenous Plants in Vt., Medical virtues 

of20,171,357, 462. 
Iodine, Topical uses of, 454. 
Ipecacuanha as an external application, 460 
Iron, injections of per-chloride of in treat 

ment of Aneurism, 70. 

Laws of N. X, affecting the life and health 

of man, 154, 
League, Physicians, 97. 
Lightning, effects of, 386. 
Liniment, Aconite, 340. 



Manganese, Salts of in Chlorosis, 418. 
Medical Jurisprudence, 184. 
Medicine a State Institution, 444. 
Medicine and surgery, Naval, 23. 
Mesmeric Doctor's diagnosis, 460. 
Milk, Solidified, 493. 
Miscellany, 119,236,440. 
Moon, Alleged connection between phases 

of, and quantity of rain, 495. 
Mortality in Cities, 378 
Medical Societies, Proceedings of — 

Burlington Co. N. J., 72, 213, 404, 474. 

Camden Co. N. J., 405. 

Cumberland Co, N. J , 35, 214. 

Essex Co. N. J., 260. 

Hudson Co. N. J., 36, 406, 

Litchfield Co. Conn., 261. 

Mercer Co. N. J. ,259, 407. 

N. Y. Pathological Society, 365, 471, 
521. 

Somerset Co. N. J., 260. 

State of Pennsylvania, 319. 
Medical Society of New Jersey- 
Minutes of 88th Annual Meeting, 121. 

Case of Dr. McClintock, 123. 

Officers elected, 124. 

Report of Standing Committee, 127. 
" from Gloucester Co-, 133. 
" from Sussex Co., 138, 
„ from Burlington Co., 142. 

Laws of N. J. affecting the life and 
health of man, 154. 

Call tor Special meeting, 234. 

Noevus, Treatment by Tartar emetic 
plaster, 459. 

Necrological Record, 80,237, 378, 441. 530. 

Nerves and vessels in permanent carti- 
lages, 379. 



Paris, Letter from, 66, 70. 

Paris and Vienna, comparative advantages 
of, as places of medical study, 1 7. 

Pharmacy, Chinese, remarks on, 338. 

Pharmacy, Contributions to, 241- 

Physicians, Fees of, 339. 

Physicians, the wrongs of— the remedy, 
455. 

Placenta, New mode of removing, 333- 

Placenta Praevia, 310. 

Placenta, retention of, from irregular ute- 
rine contraction, 81. 

Poisoning from abrasion by thumb nail, 509. 

Pregnancy Protracted, 499. 

Professional Standing, 98. 

Prolapsus uteri, new mode of reducing, 442. 

Publishers, penurious, 39. 



Quinia and Tartaric acid, in intermittent 

fevers, 334. 
Quinidinia, Sulphate of, 500. 

" Reform" doctors, Reports of cases, 458. 
Rheumatism, 500. 



Serpents, Venom of, 451. 

Singultus, 210. 

Sodium, Chloride of, in intermittent fever, 
256. 

Soothing Liniment, 420. 

Speculum and its modifications, its impor- 
tance, £c, 165. 

Stomach, spasm of, 421. 

Styptic Balsam, 419. 

Sulphuric Ether and Chloroform, 418. 

Surgery and medicine, Naval, 23. 

Syrupus Manganesiae Phosphatis, 444. 

Theses, Dr. Denny's, 464. 

Typhoid Fever, Treatment of in Paris, 66- 



Ulcers, Treatment of, 240. 
Uterus, Retroversion of 379. 

Vaccination as a prophylactic, 536. 
Vectis, modification of, 497. 
Vesico-vaginal fistula complicated with 
vesical calculus, 457. 

YeJlow Fever, 447. 



544 



INDEX. 



INDEX OP CONTRIBUTORS. 



Atlee, W. L.. M. D., 393, 426. 

Brown, W. M., M, D., 89. 

Budd, A. E., M. D., 149. 

Butler, S. W., M. D., 49, 147, 154. 

Coleman, I. P„ M., D. 53.. 151. 

Condict,S. L., M. D., 127. 

Day, J. L., M. D., 97. 

Denny, A., M. D., 465. 

Doane, George H., A. M., M. D., 17. 

Gardner, A. K., M. D., 165. 

Garnett, A. Y. P., M. D., 98. 

Garrison, J. F.,M,D., 133. 

Gauntt, F., M. D., 142. 

Griscom, John H., M. D., 350. 

Hunt, William, M. D., 327. 

Hunton, Ariel, M. D., 20, 171, 357, 461. 

Jenkins, J. F„ M. D., 365, 471, 521. 

Johnson, Wm., M. D., 5, 81, 210, 301, 421 

Lehlbach, Ch. F. J., 253, 379, 418. 



Luther, Martin, M. D., 519. 
Maull, D. W., M. D., 391, 509. 
Member of American Medical Associa- 
tion, 26, 41, 175, 215, 341, 501. 
Mulfbrd, I. S., M. D., 184. 
Parrish, Joseph, M- D., 13, 63, 92,205, 313, 

Patterson. H. S., M. D., 106—115, 194— 

200, 201, 222—226. 
Phillips, J. B , 66. 
Read, Z., M. D , 428. 
Ryerson, Thomas, M. D., 138. 
Secretaries of Medical Societies, 35, 36, 72, 

121, 213, 214, 232, 259, 260, 404—407, 

474, 521. 
Smith, E. D. G, M. D., 256. 
Stuart, James H., M. D., U. S. N., 22. 
Taylor, O. H., M. D., 310, 386. 
Walker, J. R., M. D., 319. 



EMBELLISHMENTS. 



Steel engraved Portrait of Jonathan Knight, M. D. 
" " « of A. H. Stevens, M. B. 

M " " of John C. Warren, M. D. 

- " « of R. D. Mu&sey, M. D. 



THE 

NEW JERSEY MEDICAL REPORTER. 

VOL. VII. JANUARY, 1854. NO. I. 

On Post Par turn Hemorrhage attended with firm uterine contraction. 
By William Johnson, M. D. 

When we advert to the numerous and erudite monographs on uterine 
hemorrhage, I may subject myself to the charge of supererogation, by 
the farther discussion of the subject. But when we realize the tremen- 
dous responsibilities which devolve upon the accoucheur ; that he is in- 
strumentally the arbiter of the destinies of the most interesting portion 
of our race, and that by his neglect or mal-interference, the strongest and 
most endearing links of humanity may be disruptured : — I say when we 
take into consideration the magnitude of this subject, and the importance 
of the accoucheur being thoroughly instructed in his responsible office, I 
shall meet with indulgence in its renewed presentation ; and in fact, such 
is the constitution of our nature, that in science, as well as in religion, 
we need " line upon line and precept upon precept." 

Of all the accidents to which the accoucheur is subjected in the dis- 
charge of his professional duties, none is of more frequent occurrence ; 
none excites deeper interest, and none requires more professional tact, 
than uterine hemorrhage. On the correct management of these cases, 
often depend the lives of individuals, and the happiness of families. Hence 
the vast importance of the accoucheur being thoroughly indoctrinated in 
every department of obstetrical science. 

It is not my purpose at this time to treat of uterine hemorrhage in 
general, but to direct attention to that particular form of it, which is de- 
signated by the caption of this article. It is post partum — the placenta 
has been expelled — the uterus feels firmly contracted to the hand — there 
may be, or there may not be, pain ; sometimes, however, the pain is as 
intense as the throes of labor ; and with this condition of the uterus there 
is hemorrhage — sometimes extremely profuse. Now this condition of the 
organ, and this manifestation of symptoms must have been cognizant to 
every accoucheur engaged in extensive practice, Still we find very little 



6 Original Communications. [January, 

notice of this, peculiar form of hemorrhage in systematic works on 
midwifery. Nearly all our best writers are silent, I believe, on this 
subject. The attention of the profession has, however, lately been 
called to it, by an article from the pen of Dr. Francis H. Ramsbotham. 
This gentleman is already favorably known to the profession, by his 
very erudite work on the " Process of Parturition." In that work 
the doctor very briefly adverts to this peculiar form of hemorrhage. 
He has, however, lately detailed seven interesting cases which 
have fallen under his observation within a year. From this he justly 
concludes that it is a circumstance of no rare occurrence. Now this con- 
dition of uterine contraction with profuse hemorrhage is every way cal- 
culated to puzzle and greatly embarrass the young practitioner. He re- 
cognizes in the firm contraction and hardness of the uterus, and some- 
times even diminished size of the organ, that very condition which the 
high authority of Dr. Dewees assures him, insures the safety of the pa- 
tient; and yet she is bleeding to death. How are we to explain this 
anomoly ? What is here the ipse morbus — the real pathological condi- 
tion of the uterus ? It is simply this. Some part of the internal sur- 
face of the uterus is coated with a firm fibrinous deposit from the effu- 
sed blood, which is so firmly adherent that the most violent uterine con- 
tractions are insufficient for its dislodgement. Such is the explanation 
given by Dr. Ramsbotham, and he states that he has seen a mass of this 
fibrinous deposit, which had been so adherent to the uterus, that the 
greatest portion of the red globules had been squeezed out by repeated 
uterine contractions, so that the mass was almost white.* 

This explanation accounts for the intensity of the pain experienced in 
this condition of the uterus — that this -pain is produced by the ineffectu- 
al efforts of the uterus to empty itself; but does it explain the profuse 
hemorrhage attendant upon such a degree of uterine contraction ? Will 
I subject myself to the charge of professional heterodoxy by the follow- 
ing additional explanation, viz : The uterus in this affection is somewhat 
in the state in which we find it in cases of encysted placenta — of hour- 
glass contraction. There is in these cases irregular, but firm contraction 
of the uterus — often severe pain and profuse flooding. Some fasciculi of 
muscular fibres are acting inordinately ; others are quiescent ; a large 
portion of the uterine vessels over which the placenta was implanted are 
patulous, and pouring out blood profusely, from that portion of the ute- 
rus not subjected to contraction; whilst in that portion in which contrac- 

* Dr. Ramsbotham has found the adhesion of this fibrinous deposit to the uterus 
as firm as that of an adherent placenta. ' 



1854.] Johnson — Post Par turn Hemorrhage, 7 

tion is vigorous, there is occlusion of the vessels. This I grant is mere 
speculation, and I am aware that another explanation may be given of 
this circumstance. I am not, however, tenacious of my opinion, or dis- 
posed to dwell longer on this point. 

We have now ascertained that although the placenta and membranes 
have been expelled from the uterus, there is yet foreign material remain- 
ing, which the organ is unable to rid itself of, and that this material is 
of firm, fibrinous formation, and that its presence keeps up hemorrhage, 
endangering the safety of the patient, and adding vastly to her suffer- 
ings. And now what is the indication ? Obviously to empty the womb 
by the introduction of the hand, and to scoop out the offending body. I 
have, from the very commencement of my medical career, been governed 
by this plain and obvious principle; that where the womb was unable to 
accomplish this emptying process, to render manual aid. 

Whilst I would deprecate too much officiousness on the part of the ac- 
coucheur in accelerating natural processes, I would equally deprecate 
that inexcusable inactivity which would suffer the flood-gates of vitality 
to remain unclosed, and see life ebb away without resorting to the most 
rational means for arresting the mischief. We will suppose that plumbi 
acetas, secale cornutum, abdominal friction, cold applications, have been 
fairly tried, and hemorrhage has not been arrested : let the right hand 
be lubricated with some unctuous substance, and passed into the uterus, 
whilst the left hand applied to the abdomen, firmly supports the fundus 
uteri. Let uterine contraction be now solicited by the hand within the 
womb, and let all the coagulated blood be scooped out, and we will often, 
be surprised at the relief which we have given to our patient. 

I could add considerably to the number of cases which Dr. Ramsbo- 
tham has given in illustration of the affection which we have been con- 
sidering. But I do not know whether it would be interesting or profita- 
ble so to do. Let one suffice. I was called up about 4 o'clock in the 

morning, some six years ago, to attend the wife of the Rev. Mr. T . 

This lady was healthy, aged about 22 years, and in labor with her first 
child. I found the vagina and external parts prepared for the passage of 
the child. The membranes soon ruptured. The presentation of the head 
was good, and the labor was an easy one. The child was born early in 
the morning. It was small. The placenta was not retained long. There 
was no unusual discharge. The uterus was hard and well contracted, 
and more diminished in size than usual. I applied the broad bandage 
to the abdomen, and adjusted my patient in bed. I remained with the 
family until after breakfast. When I went up stairs to take leave of 



8 Original Communications. . [January, 

my patient, I found that she had rather more after pain than is usual in 
a primipara case, but no other circumstances to elicit attention. I left 
her an anodyne and some plumb, acet., to be taken if the circumstances 
of the case should indicate their use. I had not been at home more than an 
hour, when I was again summoned to Mrs. T. She had taken the arti- 
cles prescribed for her, but had obtained no relief. I found her agoniz- 
ing with pain, flooding profusely, pallid and disposed to syncope. The 
womb was as as much contracted as is usual at this period, after delivery. 
I passed my hand immediately into the womb, and scooped out a handful 
of firm, adherent, fibrinous deposite. The relief was immediate — the 
flooding ceased ; the pain left her, and her recovery progressed without 
another untoward symptom. 

Another case has very recently occurred to me, as follows — 
Mrs. R., sent for me at 5 o'clock in the afternoon, of November 19th. 
She was in labor with her fifth child. The membranes had ruptured two 
hours previously, with merely a slight uneasiness in the womb. Pains 
set in, and although at rather long intervals, were increasing in force. I 
found the os uteri dilated to the size of a dollar, low in the pelvis and 
very dilatable. The vagina and external parts were prepared to admit 
the passage of the child. The presentation was that of the head, and in 
the first position of Baudeloque. The pains continued to increase in se- 
verity until 7 o'clock. As this lady had, in all her confinements, been 
subject to profuse hemorrhage, I now gave her one drachm of tinct. ergot, 
and repeated it at intervals of twenty minutes, until she had taken 
three drachms. The child was born at eight o'clock. There was none 
of that continuous pain, which results from the action of ergot on the 
womb. The article was either of an inferior quality, or else there was 
idiosyncracy in the patient. Immediately upon the expulsion of the 
child, I gave another drachm of ergot. But very soon after I had tied 
the cord, and removed the child, hemorrhage, as usual with her, set in, 
and was profuse. The uterus felt firmly contracted, but I suspected en- 
cysted placenta. She had by this time lost a considerable quantity of 
blood, and I thought it proper to introduce my hand in utero. My sus- 
picions with respect to hour-glass contraction were verified. I found a 
small portion of the placenta hanging out of the uterus, but I had pene- 
trated but a little further when I encountered a stricture, which I was 
really afraid at first, would prove impenetrable. It would scarcely 
admit two fingers, and felt almost as firm as sole leather ; but by placing 
my fingers, so as to form a cone, and pressing continually, but gently 
against the opening, my hand in a few minutes entered the upper cham- 



1854.] Johnson — Post Partum Hemorrhage. 9 

ber of the hour-glass, in which I found the greatest portion of the pla- 
centa. It was easily removed, and the blood fairly evacuated from the 
womb. I excited its contractions, and gave my patient ten grains plumb, 
acet. and another drachm of ergot. I gave her two more doses of the 
lead, each containing five grains, in a very short space of time. Cold ap- 
plications were used to the abdomen. Still she continued to saturate 
cloth after cloth, she now became faint and danger was impending. I 
turned her over on her back with a view of passing my hand into the ute- 
rus. This organ was firmly contracted and even diminished in size, more 
than usual at this period after delivery. Yet she was flooding alarmingly. 
I passed my hand into the vagina, but could not introduce it fairly into 
the uterus on account of its contracted condition, and without using so 
much violence as would have been incompatible with the integrity of the 
organ. I however, removed a handful of the firmest and most adherent 
fibrinous 'deposit that I have ever witnessed. The hemorrhage imme- 
diately ceased, so that from being obliged to have the saturated clothes 
removed from the vulva every five or six minutes, it was not necessary 
to change them again in twelve or fifteen hours. The pain now left her 
and she became comfortable. She is now doing remarkably well. 

The points of interest in this case are these — the great proclivity to 
hemorrhage in this patient — the utter failure of haemostatic remedies — 
the supervention of fibrinous deposit after the womb had been once fairly 
emptied — the immediate relief obtained by the removal of this deposit, 
and the complete check given to the hemorrhage. I do not recollect 
another instance, where I have been obliged to introduce the hand twice 
upon the same patient, at the same accouchement for the arrest of he- 
morrhage. 

In my concluding chapter, it is proper that I devote a brief considera- 
tion to the only therapeutic measure in which I can place reliance in the 
management of the peculiar form of uterine hemorrhage, which has been 
the subject of this essay — namely the introduction of the hand in utero. 

I am aware that I now enter on debatable ground, and that obstetri- 
cal writers are pretty nearly divided pro and con, on the propriety of 
introducing the hand in post partum hemorrhage. On the negative 
in the fore front of the phalanx stands our own highly and deservedly 
esteemed Dewees. I bow with deference to the high claims of learning 
and experience. But I cannot more readily subscribe to medical, 
than to ecclesiastical infallibility. I claim the right of private judgment, 
and what I ask for myself, I willingly accord to others. 

When we take into consideration the nature of that peculiar kind of 



W Original Communications. [January, 

uterine hemorrhage, of which I have been treating, I think there can be 
but one opinion as to the course of conduct which is indicated. Nothing 
but the introduction of the hand, and scooping out the adherent fibri- 
nous deposit will rescue the patient from impending danger, and present 
suffering. The only question which I think can be agitated, is the safe- 
ty of the measure, and the amount of suffering to be endured by the pa- 
tient; but when we look at the object in view, every consideration should 
be merged in that of the safety of the patient. The introduction of the 
hand in utero, when coolly and gently performed is a safe measure \ and 
when we recollect that the parts through which the hand must pass, have 
already undergone immense distention, and are still more relaxed and di- 
latable, in consequence of hemorrhage, the amount of pain which the wo- 
man will be called upon to endure will not be found to be very great. 
Let not the patient be terrified by our manner, or our preparations, but 
make to her the simple announcement that her safety requires the adop- 
tion of the measure, and that she will not be put to much suffering by it. 
She seldom will object, and never obstinately. 

Let not the reader suppose that I attach undue importance to the in- 
troduction of the hand in post partum hemorrhage, or that I give it an 
improper prominence, or that I advocate an indiscriminate^ resort to it. 
Far be it from me to have produced such an impression ; much as I value 
this resource of our art, I should be sorry to have it abused. But there 
are cases, in which I consider it to be indispensable ; such are those 
which have been the subject of this essay. Far the greatest majority of 
cases of uterine hemorrhage may be conducted to a favorable termination, 
without resorting to this measure. They will yield to the judicious em- 
ployment of abdominal friction, secale cornutum, plumbi acetas, and cold 
applications. But never let the patient's safety be hazarded by too long 
delaying the operation of this very efficient measure. In fact, I have 
encountered a considerable number of cases of post partum hemorrhage, 
where the discharge has been so very profuse — the drafts on vitality so 
large, that I have not dared to waste time in resorting to internal means, 
but have introduced the hand at once into the uterus, to excite its con- 
tractions; and I can solemnly aver that I have never, in a single instance, 
seen any unpleasant effects whatever, either direct or remote, from the 
measure, or have I in my cooler moments regretted this course, or found 
any reason in the judgment of my own conduct to condemn myself for it. 
If success be any evidence of correct practice, (and I cannot think it a 
mean evidence,) I may simply state, that I have never lost a patient with 
uterine hemorrhage. Permit me hers to relate an anecdote, which, while 



1854.] Johnson — Post Partum Hemorrhage. 11 

it may subject me to the charge of egotism, will strikingly corroborate 
the propriety of the course, which I have advocated. Some years since, 
I had a conversation with my esteemed brother-in-law, the late Dr. Cor^ 
son, of New Hope, on post partum hemorrhage, in which I dwelt upon 
the necessity of the immediate introduction of the hand, in cases of unu- 
sual violence. Shortly after this conversation, the Dr. was called to an 
obstetric case, which went on very happily, and he put the patient to 
bed; but he had not left the house, before he was summoned again up 
stairs to his patient, whom he was told was flooding to death. He was 
at her bed-side in a few minutes. Such a profuse hemorrhage, he assur- 
ed me, he had never before witnessed, and that he never before had had 
his feelings so painfully excited. He passed his hand (which was a 
large one, for he was a large man), immediately into the womb. The 
hemorrhage was instantly arrested. " Thank Dr. Johnson," says he in 
parting with the husband, "for the life of your wife, for it was by acting 
out his suggestion that she has been saved." 

This proclivity to excessive uterine discharge is in some parturient fe- 
males, astonishingly great, so that in every accouchment, their lives are 
jeopardized from this cause. I recollect waiting upon a lady, in the early 
period of my professional life, in six of her confinements ) in five of which 
I was compelled to introduce the hand to arrest hemorrhage. I was not 
at this time fully acquainted with the value of secale cornutum. I have 
now been for several years, in the habit of giving to patients subject to 
these excessive discharges, 10 grains of secale cornutum, about half an 
hour before the passage of the child's head, and 10 grains more immedi- 
ately after the birth of the child, or what is equivalent, one drachm of the 
tincture of ergot in the same manner. Hemorrhage is now rarely trou- 
blesome. 

I have been obliged to digress more than I had intended, at the com- 
mencement of this essay ; the subject of uterine hemorrhage is so in- 
volved, as to render digression almost unavoidable. And that I may not 
be misunderstood in the measures which I have devised, permit me here 
to sum up my management of post partum females. Immediately after 
the expulsion of the placenta, I renew the palpation over the uterus, 
which I had previously employed, and excite its action by gentle friction. 
As soon as I feel the organ firmly contracted, I apply the broad bandage 
to the abdomen, a cloth to the vulva, and adjust the patient in bed. I 
remain with her from half an hour to one hour. 1 frequently make in- 
quiry as to the state of the discharge ; if told that it is too profuse, I 
request to see her napkin. If I find it to be so, and an absence of paia, 



12 Original Communications. [January? 

I examine the abdomen and endeavor to excite the action of the womb 
in the way already stated. I administer at the same time a teaspoonful 
of tincture of ergot or an equivalent of the powder, and repeat the dose 
in a diminished quantity in twenty minutes, and if uterine inertia be not 
now removed, I apply a large napkin dipped in cold vinegar to the abdo- 
men, and repeat it even before it gets warm, as the principal benefit from 
this application is derived from the sudden shock given by the cold. If 
these means do not succeed in arresting hemorrhage, I now pass my hand 
intra utero and excite the action of the organ, and scoop out all the coag- 
ulated blood. On the other hand, if I find too much discharge attended 
with pain, instead of ergot I give plumbi acetas in doses of three grains 
every twenty minutes, and if not successful in a reasonable time, I intro- 
duce the hand and remove the fibrinous deposit by scooping it out. The 
ergot here would only increase the sufferings of the patient, whilst it 
would be inadequate to the expulsion of the coagulum. 

I have been in the habit from the very commencement of my practice 
of leaving with every parturient patient before taking my leave of her, 
seven or eight doses of plumb, acet. with directions, that it be taken 
every twenty minutes, if unusual discharge should occur, until it be ar- 
rested. Should not the discharge be checked after the second dose, I 
direct the application of a large napkin dipped in cold vinegar to the 
abdomen, and repeated if occasion should require. I think that by these 
means, I have been instrumental in saving some valuable lives. It is 
true, that in the vast majority of cases there will be no necessity for their 
employment, but I always like to have a resource in cases of emergency. 

Before concluding this essay, I shall take the liberty of introducing a 
case, which, whilst it does not strictly belong to the subject which has 
been discussed, tends to illustrate some of the principles for which I 
have been contending, and at the same time, to show the importance in 
every instance of protracted hemorrhage, of ascertaining the precise 
cause which keeps it up. These causes are fibrinous deposit, retained 
membranes, disruptured placenta, or polypus. The last we have nothing 
to do with at present. 

I was called about 26 years since, to visit Mrs. S., who resided 5 miles 
from me. She had been delivered about six weeks before, by a neighbor- 
ing practitioner. Every five or six days since, she had had considerable 
flooding. She was pale, anaemic, bloodless. I did not learn that her 
medical adviser had instituted an examination per vaginam, to ascertain 
the cause of this unnatural discharge. I found the os uteri patent and 
could detect a foreign body, which I believed to be a ruptured placenta, 



1854.] Parrish — Change of Life in Women. 13 

I introduced my hand into the vagina, and the greatest portion of it 
within the uterus, and removed a portion of placenta as large as a hen's 
egg. Her recovery was rapid and complete. 
White House, December, 1853. 



" The Change of Life," in Women ; with remarks on the periods 
usually called "Critical." 

By the Editor. 

Introductory Remarks— Specialities ; abuse of the Speculum ; Errors of Popular 

Opinion ; Changes Natural. 

I propose to offer in the present, and subsequent numbers of this jour- 
nal, a series of essays upon the subject designated by the above title, 
to which the candid attention of the profession is invited. It is 
one, not usually treated of in books to any considerable extent, and it 
is feared, not regarded in general practice, in the light which nature, and 
sound views of science would dictate; and as the investigation of it 
may elicit some novel reflections which are opposed to generally 
received notions of the subject, I enter upon it with cautious defer- 
ence to recognized authority, and yet, I trust, in the spirit of indepen- 
dent enquiry. While I would urge that the changes in the life of 
woman should be met by her professional attendant, with an honest re- 
gard for her welfare — that he should consider them as appointed times 
in her history, and not as outbreaks of an erratic nature, or as accidents, 
in the working of a delicate machinery — I would have the profession 
gracefully to shrink from undue interference with the operations of na- 
ture, and save itself from the imputation of rash meddling with the wise 
and essential developments of natural law : that it may not be said of 
any of her votaries, 

" fools rush in, where angels fear to tread." 

In these times when specialities are becoming the order of the day in 
medicine; when physicians, are apt to select some particular subject 
upon which to display their talent, and exercise their skill, there is great 
danger of exaggeration, both as to the nature, and treatment of the par- 
ticular diseases that may claim attention. And though it be true that 
greater light may be elaborated by such special investigations, it is well 
to guard against, at least extravagant error. With reference to the mat- 
ter before us, we fear there is more error than may be freely confessed. 
Woman herself, according to the custom of the day, has made up her 



14 Original Communications. [January^ 

mind that these changes are always more or less dangerous ; and the phy- 
sician is too often tempted, to accord with her prejudices, and to subject 
her to treatment, sometimes the most unscientific in its character, and in 
its results, most unsatisfactory, except to the pecuniary taste of the pre- 
scriber. While I would not apply this remark to the whole profession, I 
would appeal to the observation and conviction of all, and ask, — Is there 
any subject within the domain of medical science, that is more frequent- 
ly presented by the empiric, than that of female disease T — Are there not 
more "cures" offered through the press, and in the social circles of females, 
for the so called diseases of this class, than any other ? Does not almost 
every paper contain advertisements of specifics to conduct females safely 
through their " critical periods "? And even within the ranks of legiti- 
mate medicine, are there not hundreds of physicians scattered through 
our land, who are running, with wild enthusiasm into false theories, and 
adopting injurious practice, with reference to the uterine system. 

What can be more humiliating to a high standard of professional 
honor and probity, than to see a man, who may honestly enough, 
and with propriety, devote himself to the study and cure of female 
diseases, stoop to the practice of examining with the eye, all 
cases of suspected disorder, or displacement of the uterus ? Taking 
young girls from the school or the nursery, and exposing them 
to the degrading practice of ocular inspection. There are cases when 
this course may be indicated; but to aver that the practice should 
become common, is an absurdity, against which all past experience m 
medicine, all decency in morals, and all honor in manhood, should ex- 
claim with unceasing opposition. Instances have come to the knowledge 
of the writer, where through the officiousness of a so-called " womb doc- 
tor," young ladies, just developing into maternal proportions, and expe- 
riencing the sensations peculiar to that particular age and condition, have 
been suspected of uterine disease, and exposed without the least necessity, 
to having the vagina dilated by a speculum or bougie, so that the 
operator, and friends of the patient, might have an opportunity of "seeing 
for themselves," the appearance of the organ. Credulous and anxious 
mothers, superstitious nurses, and meddling female friends, were perhaps 
called to witness that the diagnosis of the physician was correct, while 
they themselves could not judge between a natural or disordered appear- 
ance of the parts; and yet this speculum and bougie practice is becoming 
extremely fashionable in some places, and the physician who can boast of 
having seen the greatest number of wombs is esteemed worthy of more 
credit, than the hundreds of less officious, and yet quite as successful 



1854.] Parrish — Change of Life in Women. 15 

practitioners who have been content to use the speculum as a necessity, 
and not as an amusing boast. 

Take again the other period of life, when the uterus, to use a fa- 
miliar comparison, "retires from active service :" how common it is 
to act at this important change, as if the organ was rebelling against a 
natural law, instead of yielding to an unalterable decree ; and to impress 
the mind of the female with the belief, that she is doomed during her re- 
maining years to countless ailments, unless she submits to medical treat- 
ment. It would be just as rational for the husbandman to force open the 
advancing bud of spring, or to climb the trees of his forest to assist na- 
ture in stripping them of their falling leaves, in autumn, as to inter- 
fere with the opening bud, or the falling leaf, in the vernal and autumnal 
seasons of womanhood, unless such interference is positively demanded 
by a departure in the constitution from a natural condition. What 
these departures may be — and how they are to be managed, will occupy 
our thoughts in future. If there are pains, and sensations of an unusual 
nature, the doctor suspects, or says there is danger, — as the function of the 
organ is now to cease, — of cancer, or some kindred malady, and to judge 
that all is right, or find out what is wrong, he exhorts his patient into a 
panic ; and she, wearied with undue advice, and alarmed by her own feel- 
ings rendered morbid, and acutely sensitive by constant direction of the 
mind to herself, submits to inspection, perhaps to cauterization, and she 
escapes, if with nothing worse, perhaps with irritability of the organ, 
and deranged nervous system, that are entailed upon her for life. 

We would not disclaim against specialities — we are glad to see 
them pursued in the hands of honest and prudent men; and no one 
is more deserving of the best talent and most arduous labor, that 
our profession can supply, than that which comprehends the entire ute- 
rine system ; but we would raise a voice, and bear a testimony, be they 
ever so feeble — against the practice, that is becoming common in cer- 
tain quarters, of placing woman in that position, in which she is made 
the special victim of professional cupidity, because she is taught to be- 
lieve that she is peculiarly the subject of alarming disease ; and if the 
effort now made to shield her from offensive professional intrusion, may 
be in the least degree successful, while it may contribute to enlighten her 
as to her true position in these respects, the author will be amply reward- 
ed for his labor. 

That there are two changes in the life of women, termed critical is 
well known to all ; but that these are necessarily dangerous, is not so 
readily admitted. Every female of sufficient years, experiences one, or 



16 Original Communications. [January, 

both, in the course of her history. Every careful mother, to whom has 
been assigned the responsible charge of rearing a daughter, knows what 
it is to look forward with anxiety, to the period of pubescence in her 
growing child. The girl of twelve years becomes in her eyes a new 
being, and after her twelfth birth-day, the watchings and fears, the 
doubts, and hopes, that toss her heart to and fro, as she looks with ma- 
ternal solicitude upon the daily course of her child, are only known to 
herself. But why these conflicting emotions ! The child is well, she 
has been reared so far with a good degree of health ; and whence the 
trembling now ? 

Nature has appointed a change — a critical period. In that girlhood is 
to commence a development that is to assume a woman's nature — organs 
of the body that have have been hitherto dormant, are now to be aroused 
to actions, as essential to the health of their possessor, as they are to her 
guileless mind, novel and mysterious — she is to grow into woman's estate. 
Her bones, muscles, — all her tissues and organs, are to spread out with a 
rapidity hitherto unknown. 

In stature she becomes a woman, and in mind, more womanly. The 
mother is anxious lest any natural or artificial interruption should arrest 
the progress of nature; and then, as she passes on in her own circle of 
years, till the age of forty or forty-five, she begins to experience a new 
train of thoughts, and to have new fears, and many anxious hours by day 
and night, with reference to herself. The time is at hand, when nature 
shallj visit her with the assurance that she has reached the summit of 
maturity, and that henceforth, she will pass over the downward slope of 
life. Those very functions, the healthy manifestation of which in the 
child, she so much desired, and watched with so much care, are now, to 
cease in herself; and though she may have borne children, and had a 
goodly heritage through all the days of her maturity, now she shrinks, 
and yet rejoices. She fears lest it may not be well with her, and yet would 
be glad, because the time is past for her to become the mother of any 
more offspring. She wants to cross the line, and yet she falters. She 
knows she must, and yet she fears ; she feels that she will, and yet she 
would not. Nature has appointed another change. In that wo- 
manhood, matured by experience and care, is now commencing the pro- 
cess of decline. Organs that have contributed by their operations to 
constitute her equal to her sphere and calling, now, as in childhood, -be- 
come dormant again, and she stands upon the threshold of old age, look- 
ing fearfully forward, to years of suffering and affliction, at the very time, 
when of all others, she should be cheered with a bright prospect of an 



1854.] Doane — Removal of Cataract. 17 

easy decline, because the cessation is the kind monitor that comes, bid- 
ding her to lay aside the fears and pains of child-birth, to be released 
from the wearisome toil of the nursery, and in the full bloom of ripened 
age, crowned by experience, and wisdom, to scatter about her, in the do- 
mestic circle, and amid her little community of friends, the fruits of her past 
labors in the field of life. It will be shown hereafter, why woman should 
learn to welcome, rather than fear this change — and why her physician 
should stand by her at this interesting crisis, not to alarm, but to encou- 
rage and support her. 

The term of thirty or thirty-five years, that is embraced be- 
tween these two periods in the life of woman, may be considered 
as the time of her maturity, when the organs of the body, upon 
which these changes depend, should be in the free exercise of their re- 
spective functions ; all the processes of generation, birth, lactation, 
&c, that are peculiar to this stage of life, it is not, however, now my 
purpose to consider; ample scope being afforded for remark, upon the 
peculiarities that are developed at the appearance and cessation of the 
menses ; and as these are seasons in woman's history, that are anticipated 
by such conflicting"emotions, it becomes the physician to study well the 
course and results of their development, both as to the moral and physi- 
cal changes that are coincident with them ; it is also proper for females 
themselves to understand their position, and to have their minds relieved 
of needless anxiety and fear at these times. We will offer the sugges- 
tion as a starting point, that these changes, although called critical, are 
natural, and are not to be interfered with, unless some abnormal symp- 
toms accompany them. 

(TO BE CONTINUED.) 



Comparative advantages of Vienna and Paris, as places for Medical 
Study, with some remarks on the Operation of extraction for the 
removal of Cataract. 

By George H. Doane, A. M., M. D. 
One of the most striking things to a medical student from this coun- 
try, visiting the Hospitals, and Schools in Europe, is the attention paid 
both theoretically and practically, to the diseases and surgery of the eye. 
A large wing of the General Hospital of Vienna, is devoted to that de- 
partment, and a Professor lectures five or six times a week during the 
sessions, which generally last nine or ten months. At Berlin, and at 
Paris, portions of the Hospitals are devoted to ophthalmic patients, and 



18 Original Communications. [January, 

extensive private cliniques attract large crowds, both of those who wish 
to have cured, and of those who wish to learn how to cure, those diseases. 
Nothing can be conceived more admirable than the arrangements at Vi- 
enna for instruction, in this, and other branches of medical, and surgical 
knowledge. Having for a short time experienced them, I regard it al- 
most as a duty to call to them the attention of those who have in view a 
visit to Europe, after the completion of their studies here. There were 
only five Americans in Vienna last winter, while Paris could boast of 
of between three and four hundred.* These latter crowded every private 
lecture-room, and clinique in the " Quartier Latin" to their own discom- 
fort, and that of the teachers } while in Vienna the same, and in many 
cases, greater facilities exist, unknown and unimproved. The latter city 
has but one hospital for general practice, but it is the largest hospital in 
the world. Its bed accommodation is four thousand five hundred. The 
building is square, intersected by various quadrangles, each devoted to one, 
or more, speciality of disease. There is one place where the post-mortem 
examinations are made, and here the student of pathology may assist at 
the daily autopsy of from fifteen to twenty, and sometimes, thirty bodies 
in the course of a morning, under the supervision of the Father of Pa- 
thology, Rokitansky. After listening to the lucid diagnosis of Skoda 
and Oppolzer, it gives the student confidence in the science of medicine, 
to see them verified by the scalpel of that great man. The Hospital is 
in fact a little world in itself. The students live around the professors, 
inside the walls of the building. Besides the distinguished names I have 
mentioned, there are Hebra for diseases of the skin, Siegmann for syphi- 
lis ; Heller for chemical pathology ; Hyrtl for topical anatomy -, Jaeger, 
Rosas, and Meyr for diseases and surgery of the eye. These latter bring 
me back to the concluding part of my theme. 

It is well known that the first attempts at remedying the disturbances 
of the organ of sight at all in a scientific manner, originated at Vienna. 
Before Barth turned his attention to the subject, to be blind, from causes 
which the merest tyro can now remove, was to be hopelessly so. The 
grossest ignorance prevailed in the highest quarters on this subject. Ac- 
cording to Boerhaave, who certainly was a shining light, "mercurius saepe 
perfectas cataractas solvit." The absurdity of this statement is so ap- 
parent as to make us wonder how it could ever have been made. It was 
in 1773 that Barth first commenced his course of clinical teaching. "A 

* In the class which attended the Spring Course of Lectures on Physiology by Ber- 
nard, and which was quite a numerous one, there were only two who were not Ame- 
ricans. 



1854.] Doane — Removal of Cataract. 19 

student of his, Schmidt, followed, and after him came one* of whom the 
University of Vienna is justly proud, as having been the great founder 
of the principles and practice of ophthalmic medicine, as we have them 
further illustrated and improved by Jaeger, his son-in-law, Graefe, 
Jiingken, Sichel, Desmarres, Mackenzie, Lawrence, &c, at the 
present day. The museum still contains one of his drawings, which show 
that it was no want of ability to design, and color, that led him to aban- 
don painting, his first profession. It is wonderful to see how much that he 
did has been left untouched. The pathology he discovered, the treat- 
ment he proposed, the instruments he invented, the operations he sug- 
gested, remain in many cases as he left them. I have neither time nor 
space to descant upon all the modes, and methods, of combatting disease 
which he advocated. In the selection I have made, I have chosen the 
one of all which was his favorite. The operation of extraction for the 
removal of cataract, I think, recommends itself at first sight to our appro- 
val. Once done, and well done, it is radical. The old Celsian operation 
of couching, which it was intended to supplant, can have no such testi- 
mony borne in its favor. Who has not seen the surgeon take his seat, 
make a small puncture, and after two or the three attempts cause the 
lens to disappear. The patient announces his restoration to vision, and 
both he and the spectators, think, and report, it, a successful case. But 
there is a sequel to the story, which does not always reach the ears of 
those who were satisfied with the result. The opaque lens no longer in- 
terferes directly with vision, but it is acting slowly, and surely, as a for- 
eign body. No one questions now-a-days that it is sometimes absorbed, 
but that is always a matter of time, and before it has been effected an ir- 
ritation by its presence has been established in the ciliary processes, the 
retina, and sometimes even in the hyaloid membrane, which results in a 
total, and irremediable, loss of sight. How much better the certain, once 
for all, cure by extraction. Its difficulty should not be quoted against 
it. There are always some who can do it, and in so important a 
question no one has a right, in order that he may be the operator, to se- 
lect an operation more easy to perform, but much more uncertain in its 
result. Statistics are difficult to obtain in this operation ; but wherever 
they have been, a most decisive verdict has been given in favor of the ra- 
dical method. Professor Meyr told me that at Vienna the operation of 
couching was not done in one case out of twenty. He himself, though 
not connected with the University more than five years, has done it five hun- 
dred times. Desmarres, and Sichel in Paris make use of it whenever they 

* Von Baer. 



20 Original Communications. [January, 

possibly can ; but so far as my observation in this country has gone, ex- 
traction is the exception, depression, the rule. Among the many classifi- 
cations of cataract that have been made, there is one general one, of hard 
and soft. The testimony of these occulists, so far as their practice goes to 
show it, is in favor of extraction for the first when possible, and of absorp- 
tion by puncture through the cornea for the second, and for this I think 
they have sound reasoning, and successful experience, on their side. The 
number of young Americans whom I saw at the great ophthalmic cliniques 
of Paris, leads me to hope that we may imitate, before long, this good 
example, and instead of merely palliating, relieve all patients of that 
description who present themselves for operation. 

Burlington, November 17th, 1853. 



Observations on the medical virtues of some of the most prominent 
Indigenous Vegetables grown in Vermont. 

NUMBER I. 

By Ariel Hunton, M. D. 

In describing the medical virtues of our indigenous vegetables, I in- 
clude those exotics now naturalized, and most of them growing sponta- 
neously in this vicinity. My object in writing these papers is to record 
the experience and observation of more than forty years of active profes- 
sional life, and thereby add to the sum of professional knowledge. I shall 
not give a labored botanical description of plants, to show myself learned, 
but shall use plain language in my descriptions, and be very concise, 
merely giving the botanical name, and the common, or vulgar name, in 
a manner to be understood by readers. Many of the medical facts I 
shall relate, may by some be thought futile ; but all facts in medical 
science are worth knowing, worth recording, and of use to the thinking 
and careful practitioner. If every member of the profession, would re- 
cord facts known and discovered by himself, it would be much appreci- 
ated, and could not fail to advance the cause of medical science. 

CarminativeS,/wm Carmen — a Charm. Anciently there were individuals 
called Charmers, whose occupation was to relieve persons of painful af- 
fections, by friction over the pained part, rehearsing words of incantation, 
and using some ugly looking article as a talisman, or amulet, (such, for 
instance, as a lobster's claw). These were especially resorted to in pain- 
ful spasmodic affections, as in colic, &c. 

The application of the above class of remedies to those complaints, and 



1854.] Hunton — Indigenous Medi^il Plants. 21 

the fact that they often gave relief, gave origin to the proverb, " they 
operate like a charm." 

Heracleum Lanatum is the common Cow Parsnip : the usual name with 
us is Master wort. It is a large umbelliferous plant, growing abundantly 
on our rich alluvial bottoms, to the height of four to six feet, the seeds 
resembling those of the common parsnip, and the umbels being as large 
as a tea-saucer. 

Masterwort is a safe and efficient carminative, stomachic and stimulant. 
In flatulent eructations, which is a species of dyspepsia, and debility of 
the digestive organs, some of the vegetable bitters with the seeds of the 
Masterwort is an admirable prescription ; it removes the, distress speedily. 
The seeds are much in use in domestic practice for flatulence in the 
young and aged. They are perfectly harmless, and constitute the portion 
of the plant usually prescribed by myself. It is said by some, that the 
root is poisonous. I have repeatedly ordered the green root, with other 
articles for an alterative syrup, and never knew any ill effects from its 
use. It has been recommended in epilepsy, but its carminative effect, 
I think is its only virtue, in that complaint. 

Masterwort delights in a rich alluvial soil, but may be cultivated on 
almost any soil. I have it, as well as Angelica, growing about my build- 
ings, and in September cut the umbels and preserve the seeds. 

Mentha^ . All our mints are used in domestic practice as carminatives, 
catmints, more especially for infants. Essence of peppermint I aim al- 
ways to have on hand ; it is a warming diffusible stimulant, and carmina- 
tive. 

Teraspermuni, — tail reed or Sweet Cicily, is much used as a carminative, 
and is a frequent ingredient in quack medicines, to give the article an 
agreeable smell and flavor, and probably to correct the taste of other in- 
gredients. 

Arcliangelica atro-pnrpiirca, or Great Angelica is another of our large 
umbelliferous plants, growing on the intervales, in the same locality with 
the Masterwort] the seeds resemble very closely those of Masterwort , 
their properties are similar, the roots are much used for heavey horses. 
The stalk of the Angelica is purple, and that of the Masterwort is a light 
green, resembling worm-wood, and the leaves dissimilar, they are easily 
distinguished. 

Carum Carui — Caraway is much used in domestic practice as a carmin- 
ative for flatulent infants. This is also an umbelliferous plant. 

Panax quinquefolinm — Ginseng, called Panax because of its many sup- 
posed medical virtues, is a carminative, and a pleasant bitter, and in use 
o 



22 Original Communications. [January, 

for tonic effect; it is not so plenty as formerly, its great demand a few 
years since to ship to China, cansed a thorough gathering of it. 

Calamus AromatiCUS — Sweet flag, is a warming stimulating carminative, 
a stomachic, useful in flatulence, diarrhoea, catarrhal cough, and when 
the system needs warming and stimulating ; it will excite the secretions 
to healthy action. 

LigUSticum LevistlCUm — Lovage. This is also an umbelliferous plant, the 
root and seeds are of equal efficacy, and pleasant to the taste. It is as 
effectual a carminative for infants, as any within my knowledge. 

PffiOnia officinalis— -i^o?^, is another article sometimes used for flatulence. 

Achillea millefolium — Milfoil, Yarrow, is in use for the above purpose, 
but more frequently in diarrhoea. The root is a pungent biting, stimulat- 
ing article ; it is very effective in epistaxis, which is occasionally the out- 
let of human life. Take a handfull of the stems tops or flowers, boil in 
a quart of milk; let one afflicted with epistaxis drink this, a wine glass 
at a time, for one day, and his nose will not bleed for a month ; then repeat. 
It is an effectual remedy : I used it in my boyhood. 

The following formula is anti-emetic and carminative, useful in colic, 
griping or diarrhoea ; one drop for an infant in some herb tea ; I should 
prefer catmint. 

R f^ss essence Anise oil, ^ 

do " Cinnamon, > Mix thoroughly in strong alcohol, 
do Beefs Gull. S 

I have found this an excellent remedy in many complaints, and always 
intend to have it on hand. 

The above has been hastily written, and not very systematically ar- 
ranged. If any one is benefitted, by one new or useful idea, I am com- 
pensated for my labor. 

Hydepark, Vermont, Nov. 20th, 1853. 



CQRRRESPONDENCE. 

U. S. Brig Porpoise, Lat. 35°, 22', 47' S., Long. 12o, 09', 03", E.,> 

September 10th, 1853. } 

Mr. Editor : — Although removed to a far different portion of the 
globe from that whence my last communication was dated, I feel unwil- 
ling entirely to discontinue our literary intercourse. I had contemplated 
sending you a slight sketch of the peculiarities of medical practice in our 
Navy ; but, upon perusing a French work, " Chirurgie Navale, par Louis 
J. Saurel," only issued within the- present year, I find myself forestalled 



18&4.] Stuart— -Naval Medicine and Surgery, 23 

in the very earliest part of it, inasmuch as the practice is very nearly the 
same in one service as the other. However, supposing that many of your 
readers may not have seen the work in question, I submit to you a 
translation of chapter second of this really valuable work, and leave it 
to your own judgment to use as you please. 

CHIRURGIE NAVALE.— Chapter Second. 

Of the Practice of Medicine and Surgery on board Ships of War. 

Beyond the ordinary difficulties of the medical profession, the practice 
of Medicine and Surgery on board ships of war, presents others peculiar 
to themselves, and which long practice alone will enable one to surmount. 
Of these difficulties, some are inherent in navigation itself, whilst others 
are due to the want of many things, which one is accustomed to regard 
as indispensable. 

E will limit myself to presenting as briefly as possible, the principal 
conditions which make Naval Medicine and Surgery a special Medicine 
and Surgery. 

A ship of war, however large, is always a straitened dwelling ; because 
the number of its crew is calculated according to its size. Ships of the 
Line, Frigates, and Sloops of War alone have an Infirmary,* which they 
dignify by the name of Hospital. Nothing analogous exists on board of 
the little vessels. So that it is impossible to have a sufficient surveillance 
over the patients, to prevent them from procuring food, and even wine, 
(or whisky.) On Brigs and other vessels of the smaller classes, one can 
scarce raise two or three beds for those patients, whose serious condition 
prevents the use of a hammock. Sailors should have a good constitution 
to be able to accommodate themselves in their maladies, to the alimenta- 
ry regimen on board. They embark, it is true, some provisions parti- 
cularly designed for the sick ; but, beside their being in small quantity, 
they are far from fulfilling the end to which they were destined. They 
consist, of some cases of soup ; of beef and mutton boiled ; of milk, cho- 
colate, prunes, etc. The patients ordinarily tire very quickly of these 
provisions, which, although of good quality, always have a metallic taste 
derived from the tin boxes which contain them. This taste is some- 
times so strong, that certain patients ask eagerly to return to the ordi- 
nary nourishment of the crew. It should be added that the preserved 
meats embarked are in such small quantities, that the physician can only 
order them to men who are very seriously sick. The motions of the ves- 
sel, form a powerful obstacle to the employment of certain diagnostic or 

* Styled "Sick Bay,". in our service. 



24 Original Communications. [January, 

therapeutic means. Thus, in bad weather, when the rolling is great, it 
is sometimes impossible for the sick to lie in their beds. One is then 
obliged to fasten them, which is inconvenient. The hammock is then 
far preferable to a bed, but there are certain cases in which the sick can- 
not be laid in them : whether because attacked by diseases too serious, 
or because they have need to keep their limbs in a state of perfect exten- 
sion; which occurs in certain phlegmasia, the fracture of limbs, etc., etc. 
The cadre (suspended frame), would be most useful, because it unites 
the advantages of a hammock, — suspension and relative immobility,. — to 
those of the bed, which consists of its offering an even and resisting plane 
of a size more nearly sufficient. By giving to cadres a little larger dimen- 
sions, and suspending them so that they cannot strike against neighbor- 
ing objects, one would have the mode of lying most advantageous for 
every species of disease. But this is generally difficult to obtain, there 
being hardly any on board our ships, for the very sufficient reason that a 
cadre takes the place of two hammocks, and is much more troublesome. 

All physicians who have sailed, know that at sea it is almost impossible 
to practice auscultation and percussion with advantage. The rolling and 
heaving makes the doctor lose his equilibrium ; the crackling of wood- 
work and partitions; the noises of the interior of a ship, prevent him from 
seizing the normal or pathological sounds produced by the circulation or 
respiration. From that, arises the greatest difficulty in the diagnosis and 
treatment of diseases of the breast. 

The manual operator owes likewise some peculiar difficulties to the 
undulatory movements of the ship. It is during bad times, that acci- 
dents generally occur, which necessitate urgent operations. Often then, 
the surgeon has much difficulty in preserving a position sufficiently sta- 
ble to operate with security. Phlebotomy, so simple an operation, is 
itself sometimes rendered difficult. Often, there is no bed for the patient 
to lie on. He must then occupy a seat which has no firmness. Then 
comes a sudden rolling, which upsets the doctor or his patient, or scatters 
on the deck all the implements prepared for the operation. Another 
reason, which renders surgery more difficult, is the want of intelligent 
assistants. On the large ships, the number of surgeons is greater than 
the exigencies of the service require, whilst on those of an inferior rank, 
which are the most numerous, the surgeon has often not even an intelli- 
gent steward to act as his aid, but is obliged to content himself with: a 
landsman or apprentice boy, always taken from among the least capable 
and laziest of the crew. So that, to have his prescriptions fulfilled, he 
is obliged to act steward himself. For sometime Navy Surgeons have 



1854. J Stuart— -Naval Medicine and Surgery. 25 

demanded the creation of a corps of stewards, which should be formed in 
the Hospitals, and then embarked on Ships of "War. Thus far, their re- 
quisitions have been in vain. Not only must the medical staff be doctors, 
and surgeons; they must likewise be apothecaries.* The remedies placed 
at their disposal, are not very numerous, but suffice for ordinary circum- 
stances. The trouble of preparing remedies, when one is not an apothe- 
cary by profession, is the cause why Naval Surgeons do not ordinarily 
resort to complicated formulas; — and the sick are not the worse for it. 
Powders and solutions are the forms under which they habitually admin- 
ister medicines. The sailors have such a repugnance to physic, that the 
doctor is obliged to make them take it under his own eyes, if he wishes 
to be sure that his prescriptions are fulfilled. Even on this account, the 
forms mentioned offer a great advantage. 

The part of the doctor should not consist alone in curing diseases. It 
should also be the end of all his efforts to prevent them. But for that, 
he should enjoy such a sense of authority, that his advice should be taken 
into serious consideration. The regulations of the French Navy, seem 
to have contemplated this, for in the royal ordinance of the 31st October, 
1827, Article 618 gives to the Surgeon the right, to (t advise the Cap- 
tain of those means which he may think necessary for the prevention of 
diseases, or to arrest the progress of those which are manifested." But, 
unfortunately, the intentions of this part of the regulation are not ful- 
filled as they should be. Far from deferring to the counsels of their sur- 
geons, some commanders pretend to despise them. The fear of seeing 
their authority diminished gives to some officers, happily few, the habit 
of never yielding to advice dictated by a sense of duty.f It is not here 
the place to dilate on this subject. I will content myself with saying 
that washings in the interior of the ship too often repeated ; exercises 
under a full sun prolonged for a long time, etc., are continued systemati- 
cally on board some ships, although the impropriety of such actions has 
long since been known. 

Thus endeth the Chapter. Dr. Saurel highly approves of the plan of 
flexing the limbs to arrest arterial hemorrhage, originally proposed by 
Malgaigne, generalized by Bobillier, and mentioned in the New Jersey 
Medical Reporter, vol. vi., p. 30. His remarks on it may be found on 

* These evils, are in a great measure, rectified in our service, now. 

t Of course, in our enlightened service, these evils are unknown. Such ridiculous 
stupidity or obstinate self-opinionativeness as to believe themselves better judges of 
Hygiene than medical men, are never met with among our gallant officers. Nor do 
we ever find them claiming for themselves that credit for the health of a vessel, which 
iB due to the medical officer alone. J. H» S. 



26 Original Communications. [January, 

page 59 of the above work. He is very much opposed to the use of 
Alexandre's mechanical leeches, which he characterizes as inefficient and 
useless. See note to page 40. 

Dr. Saurel asserts that in the South Atlantic, in the neighbor- 
hood of the Cape of Good Hope, external affections, as boils, carbuncles, 
whitlows, and cutaneous eruptions are peculiarly frequent. In this as- 
sertion, my own experience enables me fully to concur. I find it de- 
cidedly true. James H. Stuart. 



AMERICAN MEDICAL ASSOCIATION. 

History of the American Medical Association. 

NUMBER I. 

BY ONE OF ITS MEMBERS. 

It has been said by some one, that associated action constitutes the 
main spring — the controlling motive power, of modern society. And 
whoever surveys, with the eye of intelligence, the present aspect and 
tendencies of civilization, will readily acknowledge the truth of the re- 
mark. 

It is by the association of capital that those great enterprises for facili- 
tating commerce and intercourse among states and nations, are being 
prosecuted with an energy and success, which threatens to break through 
the strongest barriers of nature, and make neighbors of nations on the 
opposite sides of our globe. It is by the association of mind with mind, 
in the Church, the Conference, the Presbytery, the Diocese and the 
General Convocations, that the moral force of Christendom is stirred up, 
concentrated, and brought to act with mighty power in disseminating the 
sublime truths of a glorious religion. So too, by the association of mind 
with mind, in the rapidly recurring anniversary meetings of the learned, 
not only is thought made to elicit thought, and the generous ambition of 
one, made to kindle a kindred impulse in another; but the rich and 
varied fruits of many intellects are brought to a common store-house, and 
made the common property of all. For intellectual treasures, unlike 
those of a material nature, neither become monopolized by concentra- 
tion, lost by use, nor diminished by diffusion, or communication to others. 
If it is true, that associated action constitutes so prominent an element 
in the progressive tendencies of modern society as a whole, it is no less 
so in reference to the several classes of which the whole is composed. 
And of these individual classes, none hold a more important or influen- 



1854.] American Medical Association, 27 

tial relation to all the rest, than that which is made up of the active 
practitioners of the healing art. Forced by the very nature of their 
calling, to become pre-eminently cultivators of the whole field of natural 
science and philosophy, while they have the freest possible access to the 
homes and hearts of all classes, they are daily exerting an influence over 
the physical and intellectual elements of society, second to no class in Chris- 
tendom. Hence whatever, is calculated materially to influence the charac- 
ter of the medical profession, is worthy of one page, at least, in the his- 
torical records of our race. Who, that has studied carefully the history 
of the past, but has found mention of many institutions and movements, 
which have left an impression on man's social and intellectual progress, 
and yet their founders, and the motives by which they were actuated, 
have both alike been lost in the darkness of the past ? And yet, a 
knowledge of these is not only necessary to a full comprehension of his- 
torical truth, but it presents in itself the most interesting element of his- 
tory. Of all the voluntary social organizations in our country, none are 
at this time in a position to exert a wider, or more permanent influence 
over the temporal interests of our country, than the American Medical 
Association. This assertion may startle the mind of the professional 
reader, and call forth a smile of incredulity, nay of contempt, from the 
non-professional j but let both patiently follow me to the end, and then 
judge. I am aware that the details upon which I am about to enter, may 
appear to some unimportant, to others tedious, and to all of the present 
generation, wanting in novelty and interest ) but they will appear far 
otherwise to those who shall come after us, and live when time shall 
have thrown his dimming veil over all the doings of our day. The Ame- 
rican Medical Association completed its organization, and commenced its 
actual existence in the city of Philadelphia, during the first week in May, 
1847. But a correct knowledge of its origin, and a just appreciation of 
the motives of those to whom the profession is indebted for its existence, 
requires a knowledge of the doings of certain individuals and societies 
during several years previous to the date just mentioned. If the reader 
will turn to the statistics of Medical Colleges, compiled by Dr. T. R. 
Beck, of Albany, and published in the Transactions of the New York 
State Medical Society; or to the little volume entitled, " History of 
Medical Education/' &c, by Dr. N. S. Davis, he will learn, that during 
the fifteen years intervening between 1830 and 1845, the number of me- 
dical colleges in the United States, more than doubled, leading to a most 
active rivalry, and a competition unrestrained by any mutual intercourse 
with each other, or social connection with the profession at large. Such 



28 Original Communications. [January, 

institutions, having full power to confer degrees, which were very gene- 
rally recognized as sufficient to entitle the holder to membership in the 
profession, would be strongly tempted, under the circumstances men- 
tioned, to add to the more important and legitimate inducements, short 
courses of instruction, and easy terms of graduation. Hence, sixteen 
weeks was very generally adopted as the length of the College term, and 
in some of the Schools it was reduced to thirteen. The marked inade- 
quacy of so short a term, and the evils resulting from a want of concert 
among the Colleges, early attracted attention in New-England ; and led 
to some unsuccessful attempts to remedy both. In 1835, the Faculty of 
the Medical College of Georgia, formally proposed the holding of a con- 
vention of delegates from all the Medical Colleges of the Union, and 
advocated the same through the columns of the Southern Medical and 
Surgical Journal. 

The proposition seemed to meet the approbation of those connected 
with many of the Colleges, but failed of being carried into effect, through 
the indifference of some of the older, and more influential Schools in the 
Atlantic cities. The first movement, of which we have any record, which 
contemplated a convention of delegates, not only from all the Medical 
Colleges, but also from the regularly organized Medical Societies through- 
out the whole country, was made in the Medical Society of the State of 
New York, at its annual session in February, 1839. During the same 
session the subject of medical education had been a prominent topic of 
discussion, and a resolution, declaring that the business of teaching 
should be separated as far as possible from the privilege of granting di- 
plomas, had been adopted by a large majority. It was in view of this 
discussion that Dr. John McCall, of Utica, offered the following pream- 
ble and resolution — viz : 

" Whereas, a National Medical Convention would advance, in the 
apprehension of this Society, the cause of the medical profession through- 
out our land, in thus affording an interchange of views and sentiments 
on the most interesting of all subjects — that involving men's health, and 
the means of securing, or recovering the same : therefore, 

Resolved, That in our opinion, such convention is deemed advisable and 
important ; and we would hence recommend that it be held in the year 
1840, on the first Tuesday in May of that year, in the city of Philadelphia, 
■ — and that it consist of three delegates from each State Medical Society, 
and one from each regularly constituted medical school in the United 
States, and that the president and secretary of this Society be, and they 
are hereby instructed, and required to transmit as soon as may be, a 
circular to that effect to each State Medical Society and Medical School 
in said United States. " 



1854,] American Medical Association. 29 

This proposition was adopted, and all the necessary steps taken by the 
Society of the State of New York, for carrying it into effect. But neither 
the Societies, nor the Schools of other States, not even those of Philadel- 
phia, where the proposed convention was to be held, responded to the in* 
vitation, and consequently no meeting took place. 

The subject of medical education, however, continued to be a promi- 
nent topic of discussion in many of the medical societies throughout the 
Union ; and especially the evils supposed to result from the union of the 
power to teach, and to confer degrees, or licenses to practice, in the same 
hands. And at the annual meeting of the New York State Society, in 
1844, attention was again strongly directed to the whole subject of me* 
dical education, and the necessity of a higher standard of qualifications, 
both preliminary and medical, by two series of resolutions. The one wa» 
offered by Dr. Alexander Thompson, of Cayuga Co., and the other by 
Dr. N. S. Davis, then a new delegate from Broome Co., N. Y. 

These resolutions declared a four months college term too short for an 1 
adequate course of lectures, on all the branches of medical science, and 
the standard of education, both preliminary and medical, required by the v 
schools previous to the granting of their diplomas, altogether too low ; 
while the union of the teaching and licensing power in the College Fa- 
culties, was represented as impolitic, and constantly liable to abuse,, 
These resolutions elicited some discussion, and were referred to the stand- 
ing corresponding committee, of which Dr. Davis was made Chairman. 
Through his agency, the subjects embraced in the resolutions, were urged 
upon the attention of most of the County Societies in that State, and in 
many of them, elicited action acknowledging their importance, and sanc^ 
tioning the principles they embraced. This gave the subject a more 
general interest, and at the next annual meeting of the State Society, 
held in February, 1845, two reports were presented by the Correspond- 
ing Committee j one from the Chairman, embodying the action of the 
County Societies, and recommending the principles involved in the origi- 
nal resolutions; the other, from Dr. M, H. Cash, of Orange County, 
taking a different view of the subject. These reports led to a protracted 
discussion of the whole subject of medical education ; more especially in 
reference to the standard of attainments that should be required, before 
admission into the ranks of the profession. On the one hand it was 
claimed that the standard of attainments, both preliminary and medical, 
exacted by the several Medical Colleges, was too low, or too limited, to be 
consistent with either the honor of the profession, or the well-being of the 
community ; and farther, that the union of the power to teach and grant 
4 



80 Original Communications. [January, 

diplomas in the several college faculties, co-operated with the active rivalry 
among the schools, to depress the standard still lower. On the other 
hand, while some of these allegations were promptly admitted to be true, 
it was claimed that the standard of qualifications exacted by the Colleges 
of New York State was as high as that required by the Colleges in any 
of the surrounding States ; and consequently, the adoption of measures 
calculated to compel the- Schools of one State to adopt a higher standard f 
would have no other effect than to induce the students to abandon such 
Schools for those of other States, where less extensive attainments were 
required. The latter view was more especially urged by the friends of 
such Colleges as were represented in the society ; while the advocates of 
a more liberal professional education, claimed that such position precluded 
all progress. For the institutions of each state would claim that their 
standard of qualifications, required before conferring the degree of M. D., 
was as high as that exacted by the Schools of other States, and conse- 
quently no one would venture to advance a step beyond its rivals. 

It was at the close of this debate, when the whole subject was about 
to be postponed until the next annual meeting of the Society, that Dr. 
Alden March, of Albany, privately suggested to Dr. Davis, who had 
taken an active part in the discussion, that the objection might be obvi- 
ated by calling a convention of delegates from all the Colleges, and 
thereby inducing the institutions of the several States to act in concert. 
The last named gentleman, not knowing that any previous attempts to 
assemble a National Medical Convention, had been made, immediately 
rose, and submitted the following preamble and resolutions — viz : 

" Whereas, it is believed that a National Convention would be condu- 
cive to the elevation of the standard of medical education in the United 
States ; and whereas, there is no mode of accomplishing so desirable an 
object, without concert of action on the part of the medical colleges, so- 
cieties, and institutions of all the states, therefore, 

" Resolved, That the New York State Medical Society earnestly re- 
commend a National Convention of delegates from medical societies, and 
colleges in the whole Union, to convene in the city of New York, on the 
first Tuesday in May, in the year 1846, for the purpose of adopting some 
concerted action on the subject set forth in the foregoing preamble. 

" Resolved, That a committee of three be appointed to carry the fore- 
going resolution into effect." 

This proposition led to a brief conversational discussion, in which some 
of the older members of the society related the former unsuccessful at- 
tempts to assemble a National Convention of medical men, which elicited 
a very general expression that the project was impracticable, if not poei- 



1854.] American Medical Association. 31 

tively Utopian. The resolutions, however, being strongly urged by the 
mover,— -who contended that if the object to be accomplished was one of 
acknowledged importance, its friends should persevere, although a dozen 
failures should be encountered before their efforts met with entire suc- 
cess, — were adopted, and Drs. N. S. Davis, of Binghamton, Broome Co.; 
James McNaughton, of Alban} T , and Peter Van Buren, the Secretary of 
the State Society, were named as the committee to carry them into effect. 
The chairman of this committee soon after his return to Binghamton, is- 
sued a circular containing the preamble and resolutions quoted above, 
and sent a copy to each of the Colleges and Societies known to exist 
throughout the United States ; and to many prominent members of the 
profession in sections of the country where no social organizations had 
been formed. The correspondence thus begun was actively continued 
throughout the whole year. An examination of this correspondence 
shows that the proposition to hold a National Convention met with a fa- 
vorable response from societies, colleges, and individuals, throughout the 
whole Union, except those colleges located in Philadelphia and Boston. 
To the circulars and letters addressed to the Medical College in Boston, 
and the two oldest Colleges in Philadelphia, answers were returned, re- 
spectfully declining to take any part in the proposed convention. The 
then recently organized Pennsylvania College, located in the latter city, 
returned a more favorable answer, with a promise that delegates from 
that school should be appointed to attend the Convention. The extent 
to which the correspondence had been carried, and the degree of favor 
with which the proposition for a Convention had been entertained by the 
profession, may be inferred from the following extract from the report of 
the chairman of the special committee, made to the annual meeting of 
the New York State Society, in February, 1846, viz : 

" Replies to these circulars and letters have been received from the 
following officers of medical societies and colleges, and private members 
of the profession, viz : Drs. W. W. Morris, of Dover, Delaware ; A. H. 
Buchanan, of Tennessee ; W. P. Johnston, of Washington City j T. T. 
Hewson, R. M. Huston, and W. E. Thome, of Philadelphia; Luther 
Ticknor, of Connecticut; W. H. McKee, of North Carolina; E. H. Peaslee, 
of N. Hampshire; Paul f. Eve, of Georgia; J. H. Thompson, of N. Jersey; 
J. W. Davis, of Indiana ; A. Twitchell, of New Hampshire ; John W. 
Draper, A. H Stevens, Willard Parker, and C. A. Lee, of New York ; 
D. Drake, of Ohio ; Lawson, of Kentucky ; and Carpenter, of Louisiana, 
And delegates have been freely pledged from Medical Societies and Col- 
leges, in Maine, New Hampshire, Connecticut, New Jersey, Delaware^ 



32 Original Communications; [January, 

District of Columbia, South Carolina, Georgia, Mississippi, Louisiana, 
Tennessee, Kentucky, Ohio, Indiana, and New York. Nearly every 
Medical Journal, throughout the whole Union, has not only favorably 
noticed, but warmly commended the holding of such a Convention. . * 
* * * * * It will thus be seen that, in far the larger 
part of our Union, the invitation of this society has met with a prompt 
and hearty response from the profession ; and it is with much regret 
that we find even a few institutions declining to take any part in so im- 
portant a movement. But when we consider the wide extent of our ter- 
ritory, and the great number of our institutions, all engaged, we should 
hope, in a generous rivalry with each other, the expression in favor of a 
Convention is certainly more unanimous, and more promising of good, 
than could have been anticipated. Indeed, the leading and influential 
members of the profession have long felt the necessity of some national 
action \ some central point of influence, around which the active and 
choice spirits of the whole profession can rally, and from which may be 
made to radiate an elevating, healthful, and nationalizing influence over 
the whole country/' 

In accordance with the recommendations of this report, the State So* 
ciety, appointed sixteen delegates to attend the proposed Convention, 
and accepted the invitation of the Faculty of the New York University, 
to hold the Convention in their College edifice ; commencing at 10 o'clock 
A. M., on the first Tuesday in May following. 

Besides the editorial notices, commending in general terms the propo- 
sition to hold a National Convention, which appeared in nearly all the 
Medical Journals of the country, during the year 1845, and which aided 
very much in rendering the movement successful, the New York Jour- 
nal of Medicine and the Collateral Sciences, published several communica- 
tions from the author of the proposition, Dr. N. S. Davis, and also one 
from Dr. L. Ticknor, then President of the Medical Society of the State 
of Connecticut. These may be found in the numbers of the Journal for 
November 1845, and January and March 1846. The communication of 
Dr. Ticknor, contains the first distinct proposition to perpetuate the ac- 
tion and influence of the contemplated National Convention, by organiz- 
ing out of it a permanent " National Medical Society." He says : "Con- 
sidering our extent of territory, and the number of states into which the 
Union is divided, it is by no means strange that the medical schools in 
the several states should gradually yield to other motives, than a desire 
to promote the best interests of society, by a thoroughly educated, and 
properly disciplined medical faculty. It is fairly enough implied, if not 



1854,] American Medical Association . 33 

perfectly obvious, that there exists no small degree of rivalship among 
our medical institutions, and leading medical men; not, I fear, who shall 
furnish the most valuable and best wrought article, but who shall furnish 
the greatest quantity. To furnish some antagonism to this tendency of 
our profession, which is from year to year gaining strength, influence 
and popularity, the writer knows of no one effort the profession can make, 
that promises so much, as to organize a National Medical Society, to 
meet annually, biennially, or triennially, having, if you please, a Vice- 
President, and committee of correspondence in each state, &c." 

The communications of Dr. Davis, contain a more extended considera- 
tion of the whole subject of medical education. Its then existing condi- 
tion, throughout the country, is clearly set forth, and its defects severely 
criticised by the writer, while he earnestly recommends such action as is 
calculated to accomplish the following definite objects, viz: 

" First — The standard of preliminary or preparatory education should 
be greatly elevated, or rather, a standard should be fixed, for there is 
none now either in theory, or in practice. 

" Second — We should elevate the business of private teaching to that 
position which its intrinsic importance demands. 

" Third — A more uniform standard of qualifications should be required 
of the candidates for medical honors. 

"Fourth — We should devise some mode to stimulate the ambition, 
and arouse the energies of the profession to a higher state of intellectual 
activity, and scientific inquiry." 

The importance of these propositions he illustrates at considerable 
length, and prominent among the means he urges for their practical ac- 
complishment, is the organization of " a permanent National Medical 
Society, by whose annual discussions, an exciting, vivifying, and 
healthful influence shall be exerted, over the length and breadth of the 
country, until a correct and noble sentiment is engendered in the bosom 
of every member of the profession."* 

In the same number of the New York Journal from which I have just 
quoted, the editor, Dr. C. A. Lee, in earnestly appealing to the profes- 
sion to make the proposed Convention truly national, by the attendance 
of delegates from every section of the country, makes the following allu- 
sion to a more permanent organization, viz: " But there are various other 
subjects, which would naturally come before such a Convention, of scarce- 
ly less interest and importance, and we should hope, as already intima- 
ted, that a permanent National Society would grow out of it, which 

* See New York Journal of Medicine, &c, March 1846, page 290. 



34 Oeiginal Communications. [January* 

would, like the /'British Association," meet annually, and at which, es= 
says and reports on different branches of medicine would be read, and dis= 
cussions held." In alluding to the call for the National Convention, the 
editor of the Buffalo Medical and Surgical Journal, in the number for 
October 1845, says: "None can doubt the propriety, nay, the urgent 
necessity for the adoption of some means to elevate the standard of me- 
dical education, and advance the dignity and usefulness of the profession. 
* * * \\r e f er vently hope that this movement will meet with 
general concurrence and cordial co-operation." 

The editors of the New Orleans Medical and Surgical Journal, and in* 
deed of almost all the other Journals, were equally explicit in commend- 
ing the general object. Thus far, though the Faculties connected with 
the Colleges in Philadelphia and Boston, had declined to co-operate in 
the general movement, no open opposition had been manifested from any 
quarter. 

BIOGRAPHY. 



Biographical Notice of Jonathan Knight, M. D. 

(SEE PLATE.) 

We present to our readers the following brief history of Dr. Knight's 
professional career, and though brief, it is sufficient to mark the way of 
his life with distinguished usefulness. The urbanity of his deportment, 
and the remarkable judgment with which he has directed the councils of 
the American Medical Association, when acting as its president, have 
made him one of its most useful, and popular members. 

He was born in Norwalk, Conn., Sept: 4, 1789. His father, Dr. Jon- 
athan Knight, after serving as surgeon's mate in the army of the Revo- 
lution, settled, and practised in that place for nearly fifty years : his mo- 
ther was the daughter of Dr. Asahel Fitch, of Reading, Conn. He prepar- 
ed for college under the tuition of Rev. Matthias Burnett, of Norwalk. 
Entered Yale College during the last term of Sophomore year, May, 1806; 
graduated Sept. 1808. At the commencement, gave the Latin Salutatory 
Address — taught school in Norwich and New London, for two years af- 
ter graduation. From Sept. 1810, was tutor in Yale College for one 
year : attended Lectures in the University of Pennsylvania in 1811-12, 
and 1812-13 — two courses. "Was licensed to practice by the Connecticut 
Medical Society, Aug. 1811. Received the honorary degree of M. D. 
from Yale College, Sept. 1818. Commenced practice in New Haven, 
April, 1813. Was appointed Prof, of Anatomy and Physiology in the Me- 



1854.] Proceedings of Medical Societies. 35 

dical Institution of Yale College the same year — gave the first course of 
lectures during the winter of 1813-14, and continued them for 25 years. 
In 1838, was transferred to the department of Surgery, and in this, con- 
tinues. For about 20 years has also given a short course of lectures to 
the senior class of under graduates, 

President of the Convention to form the American Medical Association 
which met in New York, May, 1846, and of the same in Philadelphia, 
May, 1847, until the organization of the society. President of the Amer- 
ican Medical Association, May, 1853. 



PROCEEDINGS OF MEDICAL SOCIETIES. 



Cumberland Co. Medical Society.— Society met at Bridgeton, Oc- 
tober 25, 1853. 

The minutes of last meeting were read and accepted, and the Treasu- 
rer's report adopted. 

Drs. B. R. Bateman and C. Butcher, Delegates to the American Me- 
dical Association, made a detailed report of the proceedings of that body, 
for which the thanks of the Society were returned, and the report order- 
ed to be be placed with the Records. 

Dr. Tomlinson read an Essay on Phlegmasia Dolens, and illustrated 
the subject by interesting cases occurring in his own practice. The 
thanks of the Society were returned to Dr. T., and the paper ordered to 
be placed on file. 

The Committee on the History of Medicine and Medical Men, in this 
county, reported some progress. It was resolved, that the committee re- 
port more fully at the next meeting. 

In accordance with a resolution of last meeting, twelve physicians sent 
in the dates of their Diplomas and State Licenses. 

Upon calling the roll, for a report upon epidemics, it was ascertained 
that less sickness than usual had occurred in the county during the sum- 
mer. In two localities, Fairton and Deerfield, it was remarked, dysente- 
ry prevailed as an epidemic. 

Dr. Bowen introduced the subject of water, conveyed through lead 
pipes, the dangers of the use of which produced an animated debate 
by a number of members. 

The delegates to the New Jersey Medical Society for 1854, are 
Drs. Tomlinson, Elmer, Ephraim Bateman, and Newkirk. 



36 Proceedings of Medical Societies. [January, 

Resolved, That a committee of three be appointed to make a report on 
the relation of medical men to quacks and quackery. The President ap- 
pointed on that committee, Drs. Newkirk, B. R. Bateman, and Elmer, to 
report at the next meeting. 

Dr. Parker was announced as the next in order to deliver the address 
before the Society. 

Present at this meeting, Drs. Bowen, Ludlam, Tomlinson, C. Butcher, 
E. E. Bateman, Sheppard, B. R. Bateman, Elmer, Ephraim Bateman, 
Newkirk, Parker, Potter. 

J. Barron Potter, Sec. 



Hudson County Medical Society. — The regular meeting of this Society 
was held at the American Hotel, Jersey City, on the 26th Oct. 1853. 

The President being absent, Dr. Charles Cook, Vice-President, took 
the chair. 

The members present were Drs. Cook, Varick, Vondy, Dummer, and 
Thomson. Dr. Alcott, the President, afterwards arrived. 

The minutes of the last meeting were read and adopted. 

Election of officers being in order — 

Dr. Charles Cook was elected President, 
Dr. Theodore R. Varick " Vice-President, 
Dr. Joseph H. Vondy " Secretary, 
Dr. John Thomson " Treasurer. 

The following gentlemen were then elected censors- — Drs. J. M. Cor- 
nelison, Charles Cook, J. H. Vondy, and John Thomson ) and Drs. Cor- 
nelison and Varick were appointed delegates to the meeting of the State 
Medical Society. 

On motion, Dr. Thomson was elected Reporter until the next semi- 
annual meeting. 

On motion, Drs. Varick and Thomson were appointed Essayists, each 
to deliver an essay on some subject connected with the science of medi- 
cine, at the next semi-annual meeting of the society. 

After hearing the histories of some interesting surgical cases, from 
different members, it was, on motion, Resolved, That the next semi-an- 
nual meeting should be held at Hoboken. 

On motion, Resolved, That the proceedings of this, and ensuing meet- 
ings be published in the New Jersey Medical Reporter. The society 
then adjourned. 

John Thomson, Sec 



18 54. J Bibliographical Notices, 87 



BIBLIOGRAPHICAL NOTICES. 



A Practical Treatise on the Diseases of Children. By D. Fran- 
cis Condie, M. D., Secretary of the College of Physicians; member 
of the American Medical Association ; member of the American Phi- 
losophical Society, &c. Fourth Edition, revised and augmented. Phi- 
ladelphia, Blanchard and Lea, 1853. 

The popularity of Condie on the diseases of children, has passed the 
work through three editions, and it now appears for the fourth time, re- 
vised and enlarged. The revision consists in a careful comparison of the 
contents of the previous edition, with the more recently recorded obser- 
vations of writers, both at home and abroad ; and the enlargement by 
the addition of such important facts, as have come to the knowledge of 
the author, either within the limits of his own observation and experience, 
or as they have been presented by others. In a few instances, pathological 
and therapeutical views are submitted, that are discordant with his own 
opinions, and in such instances, the authority from which they emanate 
is given, so that the credit, or responsibility, may rest with their respective 
authors. The general arrangement of the work, is no doubt already fa- 
miliar to most of our readers, as it is counted among the standard autho- 
thorities of the present day. It contains 732 pages, and is presented in 
the substantial style, usual with the enterprising publishers. 



A Treatise on Venereal Disease. By John Hunter, F. R. S, with 
copious additions by Philip Ricord, Surgeon of the Hospital Du Midi, 
Paris, etc. Edited, with notes, by Freeman J. Bumstead, M. D., Phy- 
sician to the North Western Dispensary, New York. Philadelphia, 
Blanchard & Lea, 1853. pp. 520. 

Our experience in diseases of the class treated of in the book before 

us, is so extremely limited, that we can do no more than acknowledge its 

high authority, and pass it as good. We often meet with books, which 

contradict our own experience in some matters, but we have fortunately 

no complaint to make of Ricord's Treatise on these grounds. Hunter 

bestowed much labor in the preparation of his writings on venereal 

diseases, and Ricord's teachings and experience seem to be decidedly 

Hunterian, while the American Editor displays considerable research and 

tact, in his notes, that are more numerous, than is sometimes the case in 
5 



38 Bibliographical Notices. [January, 

home editions of foreign works. What is needed as the foundation 
for treatment in the multiform phases of venereal complaints, is an accu- 
rate discrimination, by which the generalisms may he disentangled, and 
each variety of the malady presented in a distinct form. From a glance 
at the table of contents, we should suppose that no effort within reach of 
the present knowledge had been spared, to accomplish this object. Suf- 
fice it to say, that the reputation of those who have been engaged in the 
construction and completion of this volume, should insure for it that suc- 
cess, which should always be awarded to patient industry and talent. 



The Medical Formulary, "being a collection of prescriptions, derived 
from the writings and practice of many of the most eminent physicians 
in America and Europe : together with the usual dietetic preparations, 
and antidotes for poisons, to which is added an appendix on the endermic 
use of medicines, and on the use of Ether and Chloroform; the whole 
accompanied with a few brief pharmaceutical and medical observa- 
tions, by Benjamin Ellis, M. D., late Prof of Mat. Med. and Phar- 
macy in the Philadelphia College of Pharmacy. Fourth edition, re- 
vised, and much extended, by Robert P. Thomas, M. D., Prof, of 
Mat. Medica in the Philadelphia College of Pharmacy. Blanchard & 
Lea, 1854. 

The present edition of Ellis's Formulary is certainly an improvement 
on some of its predecessors, yet it falls short, in our humble judgment, 
in some respects, of what it should be ; especially as it has been revised 
by a new, and aspiring professor. We do not use this expression in any 
invidious sense, but we are compelled to adopt the opinion that the " ta- 
bular view of the doses of the principal articles of the Materia Medica/' 
is not much improvement to the work-; and we will illustrate this remark 
by reference to two articles alone ; first, calomel, — the dose is represented 
from gr. \ to x., while every practitioner is in the habit of administer- 
ing this remedy in doses much smaller, and larger than the two quantities 
named. Nobody would give i of a gr. as a cathartic, and even 10 grs. 
will not always answer, and as an alterative much less is often given than 
i of a grain. Would it not have been more consistent with im- 
proved science to have said, — dose of calomel as an alterative from l-20th 
to 1 or \ grain; as a cathartic from 5 grs. to Bj. This, at any rate, 
would have coincided with the practice of the times. Sulphate of quinia 
affords another example. The dose is set down from 1 gr. to 10 grains. 
As a tonic, 1 grain is often used ; as an anti-periodic, 10 grs. is almost a 
minimum dose ; twice that quantity is frequently admissible. Indeed 
many of our obstinate intermittents in malarious districts are intractable 



1854.] Bibliographical Notices. 39 

with less than a scruple dose of quinia. Here is the fault. The same 
medicine, though classified under different heads, in the body of the work, 
is not so arranged in the table. The alphabetical order does not har- 
monize with the system of classification. We are led to make these 
friendly strictures, not to detract from the value of the work as a whole, 
but to point out what, in all honesty, we hold to be an error. A tabular 
view of doses, should be a divided view, if we may so speak. Doses 
of the same medicine vary greatly in their effects, according to their pro- 
portions, and very strikingly so in the articles specified, so that students 
and young practitioners may be led to confine themselves to inefficient 
doses, if no more special instructions are furnished than in this tabic. 
We hope it will be more perfect in the next edition. 



Code of Ethics of the American Medical Association. — We would call 
the attention of our readers, and particularly of medical societies, to this 
code, recently published by the Messrs. Collins of Philadelphia, for the pur- 
pose of popular distribution. The cost is only five dollars for 100 copies. 
This excellent code should be extensively distributed in every community. 
Orders may be seDt to us, or directly to the publishers, T. K. & P. GL 
Collins, Philadelphia. 



Penurious Publishers. —The following, which we extract from the 
Stethoscope, expresses our mind exactly with regard to the subject it 
treats of. Dr. G-ooch might have added to the list, those publishers of 
medical journals, who send out their publications with the leaves un- 
trimmed, thus imposing on the time and patience of editors, besides being 
of no advantage whatever to themselves. 

"Penurious Publishers, evidently suffering under acute myopy, have 
sent us detached portions of publications, odd numbers of serials, single 
volumes, and second cast plates, doubtless for the purpose of having the 
works cheaply advertised. Wo beg to be excused from the trouble even 
of prescribing for this class of beings, who neither know their own 
interest, nor are liberal enough to invest a cent to make a dime. We 
refer them to the newspapers and starting journals. An old and rich 
publisher once told us that he made a fortune by the folly and stingi- 
ness of his competitors/' 



40 Editorial. [January, 

EDITORIAL. 



OUR SEVENTH VOLUME. 

With this number, we commence our Seventh Volume, and we enter 
upon it with more hope of permanent success, than when we first took 
our trembling pen to present ourself as an Editor, before the medical 
public. Then, we doubted our success, because we knew our own feeble- 
ness, and saw the strength that was on every hand, around us ; but now, 
we are confident that our journal, though humble and unpretending, finds 
favor with some of the best heads, and hearts of the profession, and has 
worked itself to a point of acknowledged credit among many, who once 
distrusted it as an attempt suggested by hazardous boldness. We took our 
initiatory steps in the chaotic mists of inexperience ; but after six years of 
friction with the world, we are more ready as a journalist to contend with 
jostling interests, and with confidence expect to maintain an independent, 
and perhaps a useful position. Our readers know already the character, 
and intentions of the work j but to those who intend to become readers, 
we would frankly say, that our aim is to do all the good we can for the 
profession and our common kind. We have steadily held on to the profes- 
sion of medicine, as it is acknowledged by the New Jersey Medical So- 
ciety — and while we have desired to be constantly influenced by the in- 
junction — " Remove not the ancient landmarks which thy Fathers have 
set/' we have labored to gather about these honored standards, all the 
results of improved science, and embellish them with the rich adorn- 
ments, that are constantly being contributed from the various resources 
of medical lore. It shall be our aim in the future, to do likewise. 

One word about the appearance of the Journal on its seventh birthday. 
It has grown a little — the reader will obtain more reading. It is better 
dressed, with a new style of cover, and a more substantial paper. Premi- 
ums are offered by the publisher too, for the largest, and next the largest 
number of subscribers sent in by the first of July. The premiums are 
good, and desirable. Ought there not to be a corresponding increase in 
the subscription list ? Will not our friends aid us in this matter ? -To 
our delinquent subscribers we would only suggest that they will be visit- 
ed by a circular from the publisher — we inform them, that they may be 
ready. 



1854.1 Editorial 41 

" SCHEIDAM SCHNAPPS." 

THERE is an article going the rounds now-a-days, named as above, 
that is attracting a good deal of notice ; and lest we should be con- 
sidered "out of time," if we did not call attention to it, we offer our 
friends the following suggestions. It seems to be a remarkable discovery 
that one Wolfe has made, in these times of Maine Law effort, and pro- 
gress, even a pleasant alcoholic liquor, that may be used as a beverage 
without injury, and as a medicine, with wonderful success. It is said not 
to " fire the brain," or "fur the tongue," but being "satisfying" and 
" healthful," preserves the consumer from " that fierce desire for stimu- 
lants, begotten and perpetuated by the use of adulterated spirits." And 
it is not only offered as a "specific" in many painful diseases," but it is 
said of it, that " whenever and wherever it is requisite to administer 
spirituous liquors/or any purpose, this is the liquor that should be adminii" 
iered" Wonderful discovery ! — Immortal discoverer ! But with this new 
born empiric, and his notable cure-all, and health preserver, we are not a 
little surprised to find associated, the names of a number of physicians. 
Before us is a pamphlet, setting forth the proofs and evidences of the 
purity and "medical properties" of this innocent alcoholic beverage, 
and specific for disease, and a number of pages are devoted to what 
are called certificates of physicians approving its use ; but upon examin- 
ing these credentials, we find but few of them, that are really recommen- 
datory. These medical gentlemen have either been supplied with tho 
" Schnapps," or asked by note, or circular, to accept of it, and they have 
replied as in the following extracts, which are selected for their brevity, 
though given in full, as they appear in the pamphlet. 

" I am aware of the medicinal properties of pure Holland Gin." 

" If it answers my expectations. I will be happy to prescribe it for my patients, in 
dropsical and nephritic cases." 

"I would frequently prescribe Gin for my patients, if I knew where I could get that 
which is fit for medicine." 

"That a pure article for medicinal purposes is very much needed, I fully agree with 
you." 

Such is the character of the recommendations, as they are called. 
There is scarcely an instance mentioned, in which it has been used, and 
its value certified to, and yet these medical gentlemen have allowed them- 
selves unwittingly to be brought before the public, by such a man, who 
has taken advantage of their civility, in respectfully replying to his ap- 
plications, as co-workers with himself in the sale of his liquor 



42 Editorial. [January? 

Physicians cannot be too careful to avoid these designing persons j for 
often by them, as Tupper has it — "the light of a thoughtful spirit is 
quenched beneath the bushel of commerce;" and they rejoice when they 
can ensnare honest, and fair dealing men in the traps, their own cunning 
has set* And then, if the beguiled, finding themselves cheated, expostu- 
late and resist, like the Ephesian silversmith, who made shrines for the 
G-oddess Diana, they may turn with scornful laugh, and say trium- 
phantly in the midst of their growing possessions,—" Sirs, ye know that 
by this craft, we have our wealth. " And truly, in this, is the main- 
spring of their conduct. May we not say to our brethren, in the lan- 
guage of the sainted physician, Luke,— "Take heed, and beware of 
covetuousness." These empirics are covetuousness personified. 



EPIDEMIC CHOLERA. 

Hon. Hamilton Fish, Senator from New York — the same gentle* 
man who, many of our readers may remember, so hospitably enter- 
tained the members of the American Medical Association, during its 
sessions in that city in May last — on the first day of the session of the 
present Congress, before that body was fully organized, and before the 
reception of the President's Message, and other public documents, offer- 
ed the following resolution, which was afterwards adopted : 

Resolved, That a select committee of five be appointed to consider the causes, and 
the extent of the sickness and mortality prevailing on board emigrant ships, on the 
voyage to this country, and whether any, and what further legislation is needed for 
the better protection of the health and lives of passengers on board such vessels. 

Our readers may remember that in the Reporter for September 30th, 
in announcing the prevalence of cholera in its epidemic form, in some 
parts of Europe, we expressed the fear that it would, ere long, invade our 
shores, as it seemed to be pursuing much the same course it did 
in the memorable epidemics of 1832 and 1849. In England the scourge 
seems to have met with a temporary check, yet it still lingers in the pur- 
lieus of Cripplegate and St. Martin's-in-the-Fields, in London, and in 
other of the faubourgs of that, and other of the maritime cities of Europe. 
It would be well for us, if it would remain there ; but, while such a tide 
of emigration, which, for the past few months, has been at the flood, is 
pouring its thousands on our shores, from these very haunts of disease 
and pestilence, it seems hardly possible for us to escape. Nor are we 
likely to do so, in view of the terrible mortality on emigrant ships during 
the month of November, referred to in the resolution of Mr. Fish, quoted 
at the head of this article- Of the whole number of emigrant vessels 



1854.] Editorial 43 

that arrived at the port of New York alone, twenty-eight had cholera on 
board. Of 13,762 emigrants who took passage on those twenty-eight 
ships, no less than 1,141 died of cholera, while from four to five thousand 
were afflicted with it during the passage. The epidemic generally broke 
out when the vessels were two or three days out, and ceased when they 
reached soundings on this side. 

We have no evidence other than newspaper accounts, that this plague 
is the true Asiatic Cholera, but, if it is not, it is at least blazing a path- 
way, which may the coming year, be a highway for that pestilence 
to invade our shores. This, it certainly will be, unless the present awful 
mortality is arrested. That this condition of things on board our emigrant 
ships is not without local causes, may be gathered from statements in the 
newspaper press, describing the condition of things on board those ves- 
sels. A writer in the New York Daily Times, of Dec. 1, gives the 
following description of the revolting state of affairs on board one ship, 
from which out of 700 passengers, 90 lives were lost on the passage — 

" The place where these miserable 700 were suffering, was so dark that nothing 
could be seen without a light ; the emigrants would not tell of a death, and in some 
instances, three or four would continue in a berth for two or three days beside a 
corpse, and the discovery was only made at last, by the nose of the sexton. 

The filth in this lower region was nearly knee deep, and to go through it with the 
screams and groans of the suffering, added to the offensive filth, gave you (as a minis- 
ter on board remarked), a distinct idea of hell. 

The filthiness of these emigrants, and their destitute condition, were described, but 
their recital would be too gross to repeat. It should however be made the subject of 
careful investigation, by the proper authorities. Talk of the horrors of a slave ship, 
when such horrors are at our very doors!" 

It is a matter of sincere congratulation that Senator Fish, in bringing 
this important subject to the attention of Congress, has shown his deter- 
mination to use his influence in legislating for the health, as well as the 
pockets of his constituency, and if there is any truth in the proverb, 
" Health makes wealth," by promoting the one he will surely advance 
the other. 

We believe that, but few cases of this sea plague, be it cholera or no, have 
as yet occurred in any of our Atlantic cities, though large numbers have 
been sent to the Quarantine Hospitals ; and it is to be hoped that such 
preventive measures will be adopted by our Boards of Health, as will ef- 
fectually close the avenues to its appearance among us. 

New Orleans has not been so fortunate; for it appears that that ill-starred 
city, which is just recovering from the effects of the recent severe epi- 
demic of Yellow fever, is now threatened with the horrors of cholera 



44 Editorial. [January, 1854.] 

epidemic. We are not, however, without hope that the cool weather of 
the winter months, aided by the adoption of proper sanitary regulations, 
may have a tendency to avert the threatened danger. B. 



OUR NEXT ANNUAL MEETING. 

We call the attention of the profession of New Jersey to the adver- 
tisement on second page of cover, of our next annual meeting. It is to 
be hoped there will be a good attendance. Every physician in the State, 
who feels an interest in its prosperity, and who can leave his field of 
labor for a few hours, ought to avail himself of the privilege of attending 
our annual meetings. 

American Medical Association. — We would call the special attention of our readers 
to the series of Historical articles commenced in this number, on the American Medi- 
cal Association. We can assure them that they will be eminently worthy of attentive 
perusal, coming as they do from the pen of a distinguished member of that body, who, 
both by his general literary attainments, and his qualifications as a medical man, with 
his well known attachment to the best interests of the profession as represented in 
the Association, is every way capable of writing them. 

The Portraits of the Presidents (which will alt be of steel), will appear in their proper 
places, and they shall not interfere with any other illustrations which may be called 
for in the progress of the work. 

Our readers can easily see that this enterprise, which is of national importance, ne- 
cessarily involves us in a heavy cash outlay. We could not have undertaken it with* 
out a degree of encouragement, which two years ago we could scarce have dared 
hope for, and we feel assured that to those who are interested in the prosperity of the 
Reporter, it will serve as an incentive to renewed efforts in endeavoring to extend 
its circulation. B. 

D^We hardly know whether we can apologize with the better grace to our readers 
or exchanges, for the fact that our journal appears month after month, devoid of select- 
ed matter. Our table has for months, groaned with piles of valuable exchanges having 
numerous articles marked, for transmission to our columns, and we have echoed back 
groan for groan from our inmost soul, because we could not find room for even ab- 
stracts of them. This attention on the part of correspondents is certainly exceedingly 
flattering, and we hope will not be abated an iota. Let them furnish us good matter^ 
and our word for it, the profession will respond so heartily, that we can afford to give, 
if need be, to do justice to all, one hundred pages a month. 

The Reporter is young and vigorous, and will grow just in proportion as it receives 
suitable nourishment. B. 



Several, pages of Editorial matter, comprising Editor's Table, Miscellany, Sum- 
mary, and Necrological Record, are in type, but must lie over till our next issue. 



THE 

NEW JERSEY MEDICAL REPORTER, 

VOL. VII. FEBRUARY, 1854. NO, JL 

AMERICAN MEDICAL ASSOCIATION, 

History of the American Medical Association. 

NTTMBER II. 

BY ONE OP ITS MEMBERS. 

Like all other great movements, affecting more or less the interests of 
a large number of persons, the effort to convene a National Convention 
of the members of the medical profession was not to be crowned with 
success, without encountering decided and strong opposition. The move- 
ment having originated in a State Society, and during a discussion in 
which some of the practices and privileges of the Medical Colleges were 
severely criticised, it is not surprising that it excited such a feeling of 
distrust in the minds of many of those connected with the Colleges, as 
to deter them from cordially uniting in it, And this distrust was doubt- 
less increased in certain quarters by the strong language, and, perhaps, 
too sweeping assertions, contained in one of the communications of Dr. 
N. S. Davis, in the New York Journal of Medicine, already referred to. 

The latter were made the pretext for a severe attack on the writer, 
the State Medical Society of New York, and all concerned in the move- 
ment for a National Meeting, by Prof. Martyn Paine, of the Medical de- 
partment of the New York University, in the form of a valedictory ad- 
dress to the graduating class of that institution, delivered March 11, 
1846. This address was styled «A Defence of the Medical Profession 
of the United States j" and was based on the assumption that the ac- 
tive members of the Medical Society of tfee State of New York generally, 
and the chairman of their committee, (Dr. Davis) in particular, had been 
slandering and defaming the profession to which they belonged. An as- 
sumption, however, so fully refuted by the whole history and conduct of 
£hat society and the individuals concerned, as to require no comments or 



42 Original Communications. [February, 

explanation at the present time. As a very large edition of this address 
was published, and widely circulated throughout the Union, it may not 
be amiss to quote a paragraph or two, for the purpose of enabling the 
reader to appreciate its spirit and design. On page 20, Dr. Paine says : 
" Nor shall I have discharged the office which I had assigned to myself, 
till I also place on record who they are that malign the great mass of 
American physicians, who are rendering more service to the cause of 
humanity than any equal proportion of the same profession, in the most 
favored states of Europe. It is not the man who has officially promul- 
gated the views of the State Medical Society, nor the journals through 
which the contumelious representation of the profession is circulated 7 
that should be held responsible, any farther than as they, also, hold an 
influence over the public mind, and according, also, to the animus, and 
the extent in which that influence may be exerted. We must rather go 
to the fountain from which it emanates, and with acids and caustics try its 
purity. We must go to the State Medical Society itself, interrogate the gen- 
eral character of those who annually convene at Albany, during tke very 
opportune session of the Legislature, inquire how far, and in what ways, 
they contribute to the dignity of the profession, and advance the inte- 
rests of medical science. Nor would I invite an investigation of this na- 
ture for the same reasons that I have quoted from Percival's Medical 
Ethics, were those members of the State Medical Society who annuaWy 
convene at Albany, and do the mining operations, more than a bare 
handful of the outs, and ivere they not so erroneously supposed to repre- 
sent the voice of the profession." Again, he says: "And now perhaps 
we shall have no difficulty in understanding why it is so earnestly desi- 
red to extend the term of instruction in our Medical Colleges, and also 
as a preliminary requisite to admission into these institutions. There is 
an aristocratic feature in this movement, of the worst omen, however the 
spirit, by which it is prompted, may belong to the agrarian policy: It is 
oppression towards the poor, for the sake of crippling the Medical 
Colleges." 

The foregoing are among the least exceptionable paragraphs of 
this address ; and yet they plainly indicate a feeling of bitter opposi- 
tion, if not contempt, towards those who were laboring to unite the pro- 
fession of the whole Union in one general convention. The actual influ- 
ence of this address, exhibiting as it did, a curious mixture of egotism, 
disgusting flattery of the class to which it was addressed, and bitter op- 
position to the movement for a National Convention, was very important, 
though widely different from what was desigued by its author. It has 



1854.] American Medical Association, 43 

already been stated that the Medical Department of the University of 
Pennsylvania, the Jefferson Medical College, and the local societies of 
Philadelphia, had declined to appoint delegates to the proposed Conven- 
tion, and the chief apprehension felt by the committee having charge of 
the subject, was that the absence of any representation from so impor- 
tant a locality, would seriously lessen the influence and success of the 
movement. But scarcely had the address of Prof. Paine reached the re- 
moter sections of the country, before the chairman of the committee of 
the New York State Society received a second letter from Prof. Huston of 
Philadelphia, stating briefly that they had heretofore declined to appoint 
delegates to the proposed Convention, because, it having been called to 
meet in the city of New York, and in the College edifice of the New 
York University, they had thought it calculated to attract undue atten- 
tion directly towards the Medical Schools of that city. But on read- 
ing " the very singular address of Prof. Paine/' they were satisfied that 
whatever might have been the motives of those who called the Conven- 
tion, it was not designed particularly to benefit the Medical Schools in 
the city of New York ; and hence he would immediately convene the so- 
ciety over which he presided, to take into consideration the propriety of 
appointing delegates. This was done, and twelve eminent and active 
members of the profession, in that city, were appointed to attend the meet- 
ing in N. York ; thereby greatly adding to the success of the movement. 
We have in these details a most striking illustration of that jealousy and 
mutual distrust which is engendered by rival interests, unmodified by 
free and frequent personal intercourse. We find the Faculty of the Me- 
dical Department of the New York University violently opposing the 
movement for a National Convention, and stigmatizing its authors as 
" miners" and " outs" (even after they had consented to have the meet- 
ing held in their own College-hall,) because it originated in a State So- 
ciety whose meetings they had entirely neglected, and of whose influence 
they were jealous ; while other most influential schools were withhold- 
ing their aid and co-operation, because they suspected the whole move- 
ment calculated, if not designed, to favor in a special degree that same 
School in New York. It would be difficult to illustrate more strikingly, 
that sleepless jealousy which pervaded more or less all our Medical 
Schools, springing into existence in rapid succession, as they had done ; 
or the necessity of some general organization, by which the representa- 
tives of all should be brought into personal contact and intercourse, un- 
til mutual distrust should give place to mutual respect and a common 
object. 



44 Original Communications. [February* 

On Tuesday, May 5, 1846, the delegates and members of the profes- 
sion from different parts of the United States, who designed attending 
the proposed National Convention, assembled, in accordance with the 
invitation of the New York State Society, in the Hall of the Medical 
Department of the New York University. They were called to order 
by Dr. Edward Delafield of New York, on whose motion Dr. John Bell) 
of Philadelphia, was appointed chairman, and Dr. "William P. Buel, of 
New York, Secretary, until permanent officers should be duly chosen. 
A committee was then appointed to receive the credentials of Delegates, 
consisting of Drs. H. W. Baxley, of Maryland, N. S. Davis, of N. York, 
and Richard D. Arnold, of Georgia. This committee soon reported the 
reception of credentials, containing the names of one hundred and nine- 
teen delegates, eighty of whom were present at the opening of the Con- 
vention. 

*Ihe latter number was subsequently increased to near one hundred j 
representing Societies and Colleges in sixteen different states, viz : New 
Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut, New 
York, New Jersey, Pennsylvania, Delaware, Maryland, Virginia, Geor- 
gia, Mississippi, Indiana, Illinois and Tennessee. 

A committee of one from each state represented, reported the names 
of the following gentlemen for permanent officers of the Convention, and 
they were unanimously elected, viz : 

FOR PRESIDENT, 
Dr. Jonathan Knight,* of New Haven, Connecticut. 

FOR VICE PRESIDENTS, 
Dr. John Bell> of Philadelphia, Pennsylvania; Dr. Edward Dela- 
field, of New York City. 
FOR SECRETARIES, 

I)r. Richard b. Arnold, of Savannah, Georgia ; Dr. Alfred Stille', 
of Philadelphia, Pennsylvania. 
Thus Was completed, in the midst of the most perfect harmony and 
good feeling, the organization of the first National Convention of mem- 
bers of the medical profession ever convened in the United States. And 
when we remember that the number in attendance, was at least respecta- 
ble ; that among them were many of the most eminent in the profession; 
that they were gathered from all sections of the Union, from the hills of 
New England, the broad prairies of the West, and the sunny plantations 
of the South ; not, however, for purposes of political preferment or pecu- 
niary gain, but to give each other the Warm hand of friendship, and 

* For Biography of Dr. Knight, see N. J. Medical Reporter for Jan,, 1854, p. 34. 



1854.] American Medical Association. 45 

tmite in the adoption of measures for the elevation and advancement of 
the noblest of temporal pursuits, we are constrained to regard it as one 
of the most interesting assemblages ever convened since the organization 
of the benign government under which we live. 

As soon, however, as the officers elect had been conducted to their re- 
spective places, Dr. Gunning S. Bedford, the colleague of Prof. Martyn 
Paine, and a delegate from the faculty of the Medical Department of 
the New York University, arose, and after some general remarks in re- 
ference to the benefits of a general Convention of medical men, moved 
the following preamble and resolution, viz : 

"Whereas, the call of the State Medical Society of New York, for a 
National Medical Convention, to be held in the city of New York, on 
the first Tuesday in May, has failed in a representation from one half of 
the United States, and from a majority of the Medical Colleges ; and 
whereaSj the State Medical Society has emphatically stated that there is 
no mode of accomplishing the object of the Convention, without concert 
of action on the part of Medical Societies, Colleges, and Institutions of 
all the States, therefore, 

Resolved, That this Convention adjourn sine die} 1 

This proposition was immediately seconded by Dr. G-. S. Pattison, the 
colleague of Professor Bedford, and delegate from the same Faculty. 
This proposition, coming at such a time, and directly from the represen- 
tatives of the School in whose College building the Convention had 
assembled, took every member by surprise, But after one or two minutes 
of entire silence, the question was very generally called for, and being 
taken by yeas and nays, resulted as follows— viz : 

Yeas , 2, Drs. Bedford and Pattison. Nays, 74. 

The result of the vote having been announced, considerable warmth of 
feeling was manifested by many members, who regarded the motion of 
Dr. Bedford as a deliberate attempt to break up the Convention, and as 
little less than an insult to all its members. 

Several motions were made, having for their object an immediate with- 
drawal from the College edifice of the New York University, but after 
explanations and apologies from both Drs. Bedford and Pattison, the sub- 
ject was laid on the table. A committee of nine was then appointed "to 
bring the subject of medical education before the Convention, in the 
form of distinct propositions, suitable for discussion and action." This 
committee readily agreed upon the following propositions — viz : 

First — That it is expedient for the medical profession of the United 
States to institute a National Medical Association. 

Second — That it is desirable that a uniform and elevated standard of 



46 Original Communications, [February, 

requirements for the degree of M. D., should be adopted by all the 
Medical Schools in the United States. 

Third — That it is desirable that young men, before being received as 
students of medicine, should have acquired a suitable preliminary educa- 
tion. 

Fourth — That it is expedient that the medical profession in the United 
States should be governed by the same code of Medical Ethics. 

These were reported to the Convention, with the recommendation that 
a committee of seven be appointed on each subject, whose duty it should 
be to report at a meeting to be held in the city of Philadelphia, on the 
first Wednesday in May, 1847. The same committee also recommended 
the appointment of a committee of seven, " to prepare and issue an ad- 
dress to the different regularly organized Medical Societies, and chartered 
Medical Schools in the United States, setting forth the objects of the 
National Medical Association, and inviting them to send delegates to the 
Convention to be held in Philadelphia, in May, 1847." 

These propositions were all adopted by the Convention, and the re- 
quired committees appointed. Dr. N. S. Davis, who was chairman of 
the business committee, urged the following resolution as one suitable 
to be recommended, as an additional subject for the consideration of the 
Convention. It was opposed by Dr. Hays, and other members of the 
committee, on the ground that it would be likely to excite discord, and 
was rejected by the committee. 

" Resolved, That the union of the business of teaching and licensing 
in the same hands is wrong in principle, and liable to great abuse in 
practice. Instead of conferring the right to license on Medical Colleges, 
and State and County Medical Societies, it should be restricted to one 
board in each State, composed in fair proportion of representatives from 
its Medical Colleges, and the profession at large, and the pay for whose 
services as examiners, should in no degree depend on the number 
licensed by them." 

The same resolution was subsequently handed to Dr. 0. S. Bartles, 
and by him presented to the Convention. An interesting and spirited 
discussion followed, which was participated in by Drs. Sumner, F. Camp- 
bell Stewart, Meredith Clymer, Isaac Parrish, H. W. Baxley, J. K. 
Manley, S. Hasbrouck, and N. S. Davis. Motions were made by those 
opposed to entertaining the resolution, to lay it on the table, and to refer 
it to some one of the committees already appointed. These motions were 
either withdrawn, or severally voted down, and the resolution was finally 
referred to a special committee of seven, with instructions to report on 
the same, at the meeting proposed to be held in Philadelphia, in May, 



1854.] American Medical Association. 47 

1847. On motion of Dr. John H. Grriscom, committees were appointed 
to report at the same time and place, on the most efficient measures for 
effecting a registration of births, marriages, and deaths, throughout all 
the States of the Union ; and also on a nomenclature of diseases adapted 
to the United States, having reference to a general registration of deaths. 
After passing the usual resolutions, complimenting the officers of the Con- 
vention, and thanking the Medical Colleges of the city, for freely ten- 
dering the use of their rooms for its meetings, the session was adjourned 
sine die, on the evening of May 6th, 1846. All the business of the 
Convention was conducted with decorum and the most cordial friendship, 
except that relating to the preamble and resolution introduced by Dr. 
Bedford, and even this gave rise to only a momentary feeling of excite- 
ment or rather indignation, which was quickly lost in the universal de- 
termination to act solely for the elevation and advancement of the whole 
profession. The Convention was fortunate in the selection of its officers. 
Dr. Knight, not only presided with dignity, but displayed a familiarity 
with parliamentary usages, and promptness, and pleasing urbanity rarely 
united in the same individual. In looking over the list of delegates in 
attendance, the reader will be surprised at the disparity of representation 
from States located equally contiguous to the place of meeting. 

Thus, of the New England States, Connecticut had five delegates, Mas- 
sachusetts, one ; Rhode Island, one ; Vermont, three ; New Hampshire, 
two ; and Maine none. Of the middle states, Pennsylvania had fourteen, 
two of whom represented the Medical Department of Pennsylvania Col- 
lege, while all the rest were delegates from the Philadelphia Medical So- 
ciety; Delaware had five, all of whom represented Medical Societies; 
and New Jersey had only two, who were made members by invitation. 
Of the Southern States, Maryland had one ; Virginia, three ; Georgia, 
one; Mississippi, one; and Tennessee, one. Of the Western States, 
Indiana had one ; and Illinois, one. This leaves little more than half of 
the entire number present, to represent the State of New York, while 
Maine, North and South Carolina, Alabama, Louisiana, Kentucky, 
Missouri, Ohio, Michigan and Texas, were entirely unrepresented. 
Eleven Medical Colleges were represented, constituting only about one- 
third of the whole number in the United States. The absence of a rep- 
resentation from so large a number of States and Colleges, was owing to 
various causes. In some States, neither Medical Societies nor Colleges 
existed, and individual members of the profession did not feel free to 
take upon themselves the office of delegates. This was the case in North 
Carolina ; and virtually so in most of the unrepresented States in the 



48 Original Communications, [February^ 

South and West. For though State and District Medical Societies had 
been previously organized in most of them, yet they had ceased to main- 
tain an active existence. Another cause, was a want of confidence in 
the success of the movement, 

Many, who ardently desired a full Convention, and were friendly to 
any measures calculated to elevate the standard of medical education, 
were deterred from attending, by the belief that a sufficient number of 
others would not attend, to warrant the transaction of any business of 
importance. But still another cause, which affected more particularly 
the Medical Colleges, was a feeling of distrust in regard to the motives 
of those who issued the call for the Convention. There was a feeling of 
apprehension, increased to some extent, doubtless by the address of 
Professor Paine, that the whole movement originated in a spirit of radi- 
calism and enmity to the Schools. And though such a feeling was with- 
out the shadow of a foundation in fact, yet it was evidently the chief 
cause of preventing the attendance of delegates from a majority of the 
Medical Colleges in the Union. Another feature which will strike the 
mind, in looking over the list of delegates in attendance, is the absence 
of those to whom the profession had long been accustomed to look as 
leaders in all important professional matters. We look over the list in 
vain for the names of Warren, Murray, Stevens, Chapman, Drake, and 
other veteran teachers in medicine. Almost the only ones present be- 
longing to this class, were Drs. Knight, Manley, Stevens, and Delafield, 
Hence it may be said with propriety, that the Convention was composed 
of the younger, more active, and perhaps, more ambitious members of 
the profession. 

And yet, both the discussions and action of the Convention were 
characterized by that moderation, coupled with a spirit of determined 
perseverance, which was well calculated to inspire confidence alike in the 
motives of its members, and the final success of the enterprise in which 
they had engaged. It will be noticed, that all the proceedings of this 
meeting were made to assume the character strictly of preliminary ac- 
tion. Instead of hastily declaring their sentiments by formal resolutions, 
or at once recommending measures about which there might be differ- 
ences of opinion, they simply selected the most important topics con- 
nected with the education of the profession, and referred them to able 
committees, with instructions to report after ample time for deliberation. 

They also declared the necessity and feasibility of establishing a Na- 
tional Medical Association, and appointed a judicious committee, consist- 
ing of Drs, John Watson; John Stevens; F Campbell Stewart; A. 



1854.] Butler — Doctors' Commons. 49 

Stille'; N. S. Davis; W. H. Cogswell; and E. D. Fenner, to report a 
definite plan of organization for such an Association, at a subsequent 
meeting to be held in Philadelphia. 

There was consequently no manifestation of that "agrarian" spirit, or 
enmity towards existing institutions, which Dr. Paine, and perhaps others 
had attributed to the active members of the New York State Medical 
Society ? and especially to Dr. Davis, the originator of the movement. 

From all the foregoing details, it will be apparent that the great lead- 
ing object of those who originated and carried into effect the Convention 
of May, 1846, was the improvement of our system of medical education. 

That it was very defective in many important particulars, had long 
been acknowledged by the most experienced teachers in the country. 
This will be manifest to any one, who will take the trouble to read the 
essays and addresses of Drake, Moultrie, Dickson, Beck, and others. It 
was the hope of devising measures to remove these defects, and to render 
more useful, more learned, and more honorable, the great mass of 
American practitioners; coupled with the consciousness that no mere 
local action or influence would prove efficient, which gave birth to the 
movement. And it was a very general conviction of its paramount im- 
portance, that led to such a response on the part of the profession as 
ensured its success. How far this great leading object has been kept in 
view, and with what practical results, will appear as we progress with the 
subsequent history of the Association. 



Doctors' Commons.* 
Gentlemen of the Medical Society : — 

A time-honored custom which I should be loth to violate, makes 
it my duty, before retiring from the Presidency of this Society, to read 
an essay on some subject connected with Medical Science. 

To some of you, who could draw from years of experience and obser- 
vation, facts that have been long stored up in the mind, and many times 
ruminated upon, this would be a very easy task ; but to one, who like 
myself, has only just entered within the portals of this temple, whose 
mind is in a state of transition from the chaos of medical theories and 
opinions with which it was so industriously stored in our schools, to 
the " fulness of the stature" of one, who, from experience and observa- 

*An Ethic Address, read by S. W. Butler, M. D., before the District Medical Society 
for the County of Burlington , January 10, 1854 — and published by order of the Society. 

7 



50 Original Communications. [February, 

tion, has some established principles and opinions of his own, which he 
may embody in an essay, without fear of rendering their author obnox- 
ious to the charge of presumption, — it is quite a different thing. 

In this dilemma, I have chosen for discussion, the topic already an- 
nounced : to the ear it may sound rather unique, but upon it, I 
shall endeavor to found some remarks, which I hope, will be mutually 
beneficial. 

Among the many vicissitudes of my somewhat eventful life, it has 
been my lot to travel in the wilds of the far west, unprotected and alone, 
without chart, compass, or guide. On entering a vast forest, whose tower- 
ing trees and rank foliage, almost shut from me " the eye of day" — with, 
sometimes, not even a bridle-way to shew that human beings had ever 
trod the ground before me — or, on emerging from such a forest, upon 
the borders of a prairie, whose expanse — 

" As green, as wide, and as wild as the sea," 
has stretched away until it became blended with the horizon — I have 
paused an instant to reconnoitre my position, and fix indellibly in my 
mind the points of the compass, the bearing of my place of destination, 
and to observe any landmarks which might serve to guide me in my jour- 
ney. This done, I have gone fearlessly forward, nor do I remember ever 
to have been led astray. 

Just so, having entered the temple of medical science, I would pause 
©n the threshold — would look around, and scan its fair proportions — ex- 
amine the foundations of its massive pillars — survey the span, and calcu- 
late the power of the lofty arches that support its stately and magnificent 
domes — glance at the interminable length of its " long drawn aisles" — 
and intently regard the fountains and exotics which sparkle in, and adorn 
its spacious court-yard. But I would do more — I would look aloft, con- 
sider well the object and aims of my life — my position, and the opportu- 
nities it gives me for exerting an influence for good, or for evil. I would 
earnestly scrutinize that narrow way which ascends before me by no 
winding path, to the very goal of my existence, and with a steady eye on 
that, I must fix indellibly in my mind some principles of moral conduct, 
founded on the revelation of the Divine Will, and which, once determined 
upon, must not be swerved from, " though the heavens fall." 

But we have here indicated the work of a life-time, if we have not en- 
croached on the employment of Eternity ! 

It is to be observed that while the eternal and immutable principles of 
Truth lie at the basis of the whole, there are certain foundation stones 



1854.] Butler — Doctors' Commons. 51 

upon which this noble edifice is reared, while, in the popular estimation 
at least, we ourselves, and each worshipper m the temple, constitute inte- 
gral parts of that foundation and of the structure itself. Now, it is an 
established principle in Architecture, that in proportion as the materials 
of a structure are compact and firm, will be its strength, and the degree 
of confidence placed in its durability. 

If, therefore, in the public estimation, we, individually and collectively, 
are held responsible for the amount of confidence which the science of 
medicine inspires, we must not, cannot lightly estimate this responsi- 
bility. It becomes our bounden duty to adopt any practical measure that 
may be devised, by which these integral parts may be fused into one 
whole ; for this once done in a manner apparent to the popular view, — 
inasmuch as they hold us to be its representatives, — our science must ne- 
cessarily, command the full confidence of the public. 

That it does not command the respect it did, in the days of Syden- 
ham, Fothergill, and Friend, we think is a position that will hardly be 
questioned, notwithstanding that as a science, it is very far in advance of 
the position it then held. And more, I have evidence that within the 
short period of fifty years, children were instructed to pay marked respect 
in public, to even a dissipated family physician. This is far from being 
the case now. Whence this change in public sentiment ? It is not 
without a cause : — where does it lie ? The science itself is very far in 
advance of its position fifty years ago, and is therefore deserving of far 
more respect, to which its representatives are most surely entitled. Why 
do they not receive it ? Philosophical and political reasons, and conven- 
tional customs may reasonably be adduced as causes, yet we believe there 
are others within ourselves, and for which we are, in a degree responsible, 
and which may and ought to be removed. The cause, and the remedy 
for this state of things may be stated under the following heads :• — 

1. Defective medical acquirements, including their antecedent causes. 

2. The fact that Quackery, in its various forms, — in part by its attain- 

ments, but principally by its pretensions, and the collusion with it, 
of those who pass as scientific physicians, — is leveling upwards, and 
claiming, and receiving a portion of that respect which is due the 
scientific physician alone : and, 

3. Want of union and harmony among scientific physicians. 

We have not time in this essay to discuss the positions assumed under 
the first two heads, but must confine our remarks to a few considerations 
suggested under the last. 



52 Original Communications. [February, 

Leaving out, of view, expressions having reference to that religion of 
the heart, upon which all our hopes for the future must be founded, I 
hardly know of two words that fall more heavily upon my ear, than those, 
so frequently in the mouths of the multitude, and so eagerly caught up, 
and reechoed by the press, — "Doctors disagree." The saying has become 
a proverb — " Who shall decide when doctors disagree" ? I answer, the 
public decide, and they always decide adversely to the interests of 
our noble science. I would not be understood to say that physicians 
must always agree on all points of medical doctrine and practice, or even 
perhaps of medical economy and ethics, except indeed, in so far as the 
latter are founded on that universally binding precept of our Saviour — 
" All things whatsoever ye would that men should do unto you, do ye 
even so to them/' Were this absolute union of sentiment and feeling 
in all things possible, it would scarcely be desirable, since we would 
then have to bid adieu to all hope of progress in the developments of our 
science. But I would have the members of our profession call their 
philosophy — and more, their Christianity, to their aid, in advancing the 
common interests of medical science, while they u agree to disagree" on 
minor points. " Exterior harmony is in entire accordance with the un- 
shackled maintenance of individuality." I believe it to be a fact worthy 
of especial notice, that the disagreements which so often disgrace our 
profession, are not usually founded on real differences in medical doc- 
trine or practice, but rather have their origin in those petty outbursts of 
animal feeling and passion, which hold the lowest grade in our fallen and 
sinful natures. Witness the bickerings, and quarrels which are so fre- 
quent, between members of our profession. Witness too, our courts of 
law, where, in suits brought against surgeons, for mal-practice — which, 
in nine cases out of ten, have their origin in cupidity and spite, — profes- 
sional men are found, who, with a view to advancing their own interests 
at the expense of a successful and rival practitioner, are base enough to 
give questionable evidence against him, which, in the minds of most ju- 
ries, will outweigh any array of knowledge and talent which may be 
brought forward by the defendant. 

These petty rivalries and jealousies, are as injurious to our own private 
interests, as they are to the general interests of medicine, as might easily 
be proved ; and they are as unbecoming the dignity, the philosophy, and 
the liberality of our profession, as they are often puerile in the extreme. 
Why, sirs, it is, as if two well-fed hounds, should quarrel, not over a 
bone, insufficient to afford each a mouthful of nourishment, but over a 
fat ox, capable of satisfying the craving of a dozen famishing curs ! 



1854.] Butler — Doctors Commons. 53 

If I am considered severe, and undignified in the language I employ on 
this subject, the subject, and not the pencil of the painter is responsible. 
"I confess that to a refined taste, it is course and revolting. But the pitch 
was on the canvass, 1 but touched it and am defiled!" Yet while I thus 
speak of what does exist within the pale of our profession, I am happy 
to say that I know no member of this Society, to whom these animadver- 
sions are applicable. 

I feel that nothing is now more wanting to inspire the minds of the 
community with confidence in us as medical men, and through us, in the 
science of medicine itself, than an evident union of feeling — a communi- 
ty of interest, that would not brook an evil report raised against a brother 
practitioner, and that would lead us to defend the interests of the science 
of medicine as represented in him, as earnestly, and as warmly as we 
would have him to do, were the foul tongue of slander seeking to ingratiate 
itself with him, at our expense. In other words, we need to cultivate 
more diligently those christian graces, which, like a string of pearls run 
through the whole of the thirteenth chapter of 1st Corinthians — which 
" thinketh no evil" (the wish is often father to the thought,) — which "re- 
joices not in iniquity," (or the misfortunes of our brethren), — which 
"vaunteth not itself" — " is not easily provoked," and which " suffereth 
long, and is kind." We have already quoted the divine precept on 
which all sound ethics must be founded. 

Gentlemen, you may think it bold and presumptuous, that one of 
my age and standing in the profession, should use the language I 
do here. But, I announced it as my intention at the start, to seek 
some guiding star, some way-marks, by which to thread my path through 
the mazes that lead to the goal of professional ambition, and if, in my 
field of vision there are unsightly crags and projections that will aid me, 
I presume I may use, while I endeavor to avoid them. 

"It is because I regard these flaws as unmitigated evils, because I ear- 
nestly deplore them, and because I think that every influence should be 
brought to bear, that may tend to draw more closely the cords that bind 
us together as men, and as practitioners of medicine, the "noblest of all 
professions, but meanest of all trades," that I venture to bring forward, 
for your consideration, the following plans. Should they at first view, 
seem Utopian, and impracticable, I pray my professional brethren not to 
judge and condemn them too hastily. Albeit they are the outburst of 
the youthful and ardent temperament of one who hopes and believes, that 
he is sincerely desirous of advancing the best interests of his chosen pro- 
fession, they are, nevertheless, the result of a good deal of study and ob- 



54 Original Communications. [February, 

serration, as well as of much intercourse with his professional brethren. 
I believe the plans to be perfectly feasible, and that they will bear in- 
vestigation. 

The policy which I advocate, is founded on the principle of associa- 
tion, and whatever, if any claim, it may have to originality, can be so, 
in only part of its details. For, in our State Society founded eighty-eight 
years ago, in our county Societies, in our National medical organization, 
as well as in all such associations, at home, and abroad, the principle is 
recognized, and by its very existence, triumphantly vindicated, for, had 
it not been found to work well, it would long ago have come to nought. 
It has come to be a general rule as well in the eyes of the discriminating 
public, as in our own, that he, and he only, is the respectable physician, 
who not only acknowledges fealty to some form of professional associa- 
tion, but who takes an active interest in the proceedings of such organ- 
izations. The man who holds the license of a Medical Society, merely 
for the purpose of placing himself under the aegis of legal protection, is 
a " marked man," even in the eye of the public. 

I have reason to know that plain farmers' wives, read with interest, 
the meager reports, of our too often meager proceedings, which are pub- 
lished in the newspapers, and they know who of the physicians in their 
neighborhood are present at those meetings, and what part they take in 
them.* 

The city or village newspaper, which in an u item" chronicles the fact 
that any number of physicians, either in a simply social, or in a more 
public capacity, met as physicians, and had " a good time," in so doing, 
spreads abroad the intelligence who constitutes the profession of the place 
or neighborhood. 

The day has long gone by, when a man could, attain eminence in any 
profession, or command the respect of any community, without hard stu- 
dy, and close application, and he who by his attainments is entitled to 
respect, is as irresistably drawn into association with men of kindred 
tastes, as are particles of matter by the law of attraction. 

The apparent exceptions to this rule, are like malignant growths in 
the human organism, whither the disorganized cells convey and deposit, 
their morbid material, gathered alike from the fountain head of human 
intelligence, and from " those members of the body which we think to 
be less honorable." And, if one of these exceptions should claim pre- 

* I would here respectfully suggest the propriety of having the proceedings of our 
society published by the Secretary in extenso, or, so far as may be proper for the pub- 
lic eye, in the newspapers of the day, I believe good would result from it. 



1854.] Butler — Doctors' Commons. 55 

cedence on the score of a more liberal pecuniary support, it is, as if a 
cancerous breast should exult over its healthy fellow, or a morbidly en- 
larged organ over one free from disease— for money thus acquired, is 
unhealthy material, and will as surely eat into the vitals, " as doth a 
canker." 

Notwithstanding these facts, it is well known that there are some phy- 
sicians who are backward about connecting themselves with our societies, 
and many others, who, too often honor our appointments in the breach 
rather than in the observance. I would, by increasing the inducements 
to association, bring these men into the societies, and thus enlarge the 
sphere of our influence, and, at the same time, make more apparent the 
difference between us, and the horde of pretenders, who like jackalls be- 
set our paths. I would have some bond of union, other than the mere 
abstract principle of association — some nucleus, around which we may 
cluster in a sort of " social crystalization." It is extremely difficult to 
form an attachment to an abstract principle. " Where the treasure is, 
there will the heart be also." 

In making an application of the foregoing suggestions, we will briefly 
consider them in reference to — 

1. Our State Medical Society. 

2. Our County Medical Societies, and 

3. Our City or Village Associations. 

First, then — I advocate the formation by our State Medical Society, 
of a Library, Pathological Museum, and Cabinet of Natural History. 
The Medical Society of Virginia, at its annual meeting in April last, 
laid the foundation for such a collection, and appointed a curator. 

" Many hands make light work," and the principle once established, 
and the labor heartily engaged in by the members of our society, I be- 
lieve that such a collection could be made at a very trifling expense, and 
that it would steadily grow, and be of permanent value to the profession, 
and to the State. Books and specimens in Pathology and Natural His- 
tory would flow in, and the hills and valleys of Sussex would vie with the 
plains of old Cumberland and Cape May, and our large towns and cities 
would compete with both in adding to the common stock. Every con- 
tributor to such a collection, would have a personal and an abiding in- 
terest in it, and our Annual meetings would be vested with a new inte- 
rest. Indeed, once a year, would be found too seldom for these re-uni- 
ons of the profession of the state. These collections too, particularly 
those in the pathological and natural history departments, would inevita- 
bly call forth communications and essays which would give to the trans- 



56 Original Communications. [February, 

actions of the Medical Society of New Jersey, an interest which would 
attract the attention of neighboring states, and indeed of the profession 
everywhere. These essays might always be written in a form suitable 
for binding, and thus be preserved in the archives of the society. 

The establishment of such a collection was a favorite project of the 
late Dr. James Paul, of Trenton, and had the proposition to that effect, 
which was brought before the Society at its Annual Meeting in 1852, 
been favorably received, I have reason to know that his valuable library 
would now have been the property of the State Society.* 

For the accommodation of such Library and Museum, I would ask, 
and expect, that the legislature of the state would appropriate to the use 
of the Society such room or rooms in the State Capitol as might be need- 
ed, and where all the business meetings of the Society could be held. 
The Society is a State institution, having a general, and not a local in- 
terest, and one which it is to the interest of the government to foster 
and protect, and which it will do if we are true to ourselves, — and if we 
evince a disposition to engage heartily in such a work, I have no fear 
but the appropriation would be promptly and heartily made. Legislation 
has reference to the future, as well as to the present well-being of man, 
and I ask in all candor, if such action as that proposed on the part of 
our State Medical Society and Legislature, is not fraught with benefit to 
the profession, and through them to the whole people of New Jersey. 

But, it is objected that such a collection at the State Capitol would be 
of little or no value to the profession in remote sections of the State. I 
answer, that legislation has reference to the greatest good to the greatest 
number, and, with the present and prospective facilities of travel, togeth- 
er with the necessarily frequent communication with the State Capitol, 
the large majority of the physicians of the state would have compara- 
tively ready access to the collection. Besides, the advantage to the pro- 
fession at large, which would result from the attractive force, so to speak, 
of such a Library and Museum, would far counterbalance all such ob- 
jections. These objections are not of sufficient force to prevent our Na- 
tional and State Legislatures from collecting at their respective seats of 
government, extensive libraries for the use of legislators, and no one 
questions, that notwithstanding the outlay from the public funds neces- 
sary to establish, and keep up these libraries, the money is well expend- 
ed, and that they will be of lasting advantage to the public. These Li- 
braries are often consulted by public men during the recess between the 

* I am happy to say that most of this Library is now in possession of physicians in 
this county. 



1854.] Butler — Doctors' Commons. 57 

sittings of the legislatures. What valid reason is there why physicians 
should not have equal facilities for consulting an extensive library of 
medical authors ? 

In reply to the objection that the extensive medical libraries of the 
cities of New York and Philadelphia, would render the proposed collec- 
tion unnecessary, I would simply say, that it would be as reasonable for 
our legislature to rely on the extensive public libraries of those cities as 
for us to do so, — and besides, we would not, and could not feel that free- 
dom in resorting to, and using those libraries, that we would in resorting 
to one of our own. To my mind, the argument, in any view, is clearly 
in favor of such a collection as the one proposed. 

Second. — I advocate the formation, by our County Medical Societies, 
of similar Libraries and Museums, on a scale, of course, proportionate to 
the extent of the sources from whence they are to be drawn. Inter- 
changes of duplicate copies of books, or specimens in pathology or natu- 
ral history, might often be made with the State or other County Socie- 
ties. For the county Libraries and Museums, I would ask, and expect 
accommodations in one of the public buildings of the county, for the 
same reasons that I would ask such accommodations in the State Capitol. 
Here, the county meetings, which ought to occur as often as once in 
three months, should be held. The several advantages to be derived 
from such collections, enumerated under the first head, are as applicable 
to this, and need not be repeated. 

Third, and lastly, — I would carry the same principle as far as prac- 
ticable, into our cities, towns, and villages. Wherever there are two or 
three physicians, I would have them hold a room in common, in a pub- 
lic part of the town, easy of access, and known as " the doctors 7 roomP 
Here let each physician deposit, for the time being, such books from his 
own library, and such specimens from his cabinet, as he can spare, each 
marked with his own name, and the whole properly secured in glass 
cases ; each physician being provided with keys to open them. Then, 
at suitable hours each day, let this room be thrown open to the public. 
Let there be here, skeletons of the human frame, wired and natural, for 
the inspection of the curious non-professional inquirer. Let the room be 
attractive in size and furniture, and be a common resort at all hours for 
the profession of the place, where they may meet, as they have opportu- 
nity, for social converse, and where they may hold frequent stated meet- 
ings of a professional character, and where, in the larger towns and cities, 
there may be, on proper days, certain hours in which the physicians in 

rotation, could meet, and prescribe for the poor, I need do no more than 
o 



58 Original Communications. {February, 

mention the advantage of such an arrangement to the medical student. 
The physicians might agree to subscribe for different medical periodicals, 
and thus have the advantage of receiving medical intelligence from vari- 
ous sections of the country and from abroad. The profession and the 
public too, would thus often enjoy the advantage of reference to valuable 
collections in mineralogy, botany, conchology, etc. etc., and the body of 
physicians in the place, would, necessarily command more entirely, the 
respect and confidence of the public. The trifling expense of furnishing 
such a room, is not to be thought of, in view of the great advantages that 
would result. 

Such frequent intercourse among physicians, as the proper carrying 
out of these plans would require, would make them too well acquainted 
with each other to render it possible, except in very rare cases, that any 
serious misunderstanding should arise between them, and the medical 
profession would present the grand spectacle of the devotees of a benevo- 
lent and useful science laboring unitedly, and earnestly, to promote the 
welfare of mankind. Then would this temple of science present to the 
popular view, one massive structure, whose integral parts are fused into 
a whole, against whose broad and deep foundations, the surges of popu- 
lar superstition and error dash in vain, and whose fair and. faultless pro- 
portions, as they loom up against the gathering clouds, bid defiance to 
storms and tempests. 

Burlington, iV. J.> Jan. 1854. 



Hysterical Monomania. By I. P. Coleman, M. D. 

In October, 1852, I was called to Mary , a young Irish woman, 

aged 18, affected with what I supposed to be hysterical convulsions. 
The symptoms were strong muscular movements in both upper and low- 
er extremities ; violent contortions of the body, and twistings from side 
to side, head thrown back, face flushed, eyelids closed and tremulous, 
arms forcibly brought against the breast, and hands grasping at the 
throat, with a whining cry of distress. The attendance of two persons 
was required to keep her in bed. 

The use of valerian and cathartics calmed the nervous tumult so satis- 
factorily that I made but three visits, and heard no more of the case 
until the following June. At that time rumor was busy upon the 
strange phenomena taking place at the house of her employer. I went 
thither, and obtained the following history, viz ; the nervous irregularity 



1854.] Coleman — Hysterical Monomania. 59 

had been comparatively quiet for some time after my former attendance, 
but in two or three months increased in frequency and violence, until 
the paroxysms were frightful, lasting two or three hours, with loss of 
consciousness, and disturbance of the affective faculties — patient extreme- 
ly irritable on recovery, assailing the spectators with any missile at 
hand. Complained of a gnawing and tearing sensation in the stomach, 
and during the paroxysms the epigastric distention was so great as to ex- 
cite uncharitable suspicions upon her reputation. Loss of appetite for 
ordinary food, but drank large quantities of milk when unobserved, as 
that gave most relief to the internal gnawings, and quieted the commo- 
tion so frequently present ; embonpoint well preserved, and complexion 
sanguine. The attacks were almost daily, and most frequently in the 
evening. The girl was fully of the opinion that she contained a living 
animal in the stomach. Early in June her case was stated to a celebra- 
ted doctress, who pronounced it to be either a snake or tape-worm, and 
ordered fern-root to be taken in decoction. Apparently much against 
her inclination, she was induced to drink it, when a dreadful scene ensu- 
ed. The "baste" as she termed it, was offended at the potion, turned his 
back upon it in a rage, and made desperate lunges to escape through the 
oesophagus, and once blew sand into her mouth, which she ejected into 
a basin. The intergastric evolutions continued thirty-six hours, during 
which time violent spasms and maniacal ravings were almost constant; 
a calm then ensued, and there was tranquility four or five days, at the 
end of which time a new phase was presented. Horrible sensations of 
strangulation, and violent, but ineffectual efforts to vomit came on, the 
hands were thrust furiously into the fauces, and fragments of dark tough 
skin forcibly extracted. The apparent agony during the efforts, was 
great, each paroxysm terminating with violent hysterical convulsions, 
turgid face, protruding eyes, throbbing carotids, and bursting jugulars, 
with seeming unconsciousness. Day after day such things were exhibit- 
ed, but chiefly in the evening, and always in the presence of several at- 
tendants and spectators. The quality of the material changed from skin, 
apparently having scales, to a soft, solid substance, which when dry, re- 
sembled sweet potato in fracture and odor : also, a substance similar to 
wood having undergone eremacausis, and smelling like mushrooms ; also, 
the green and ferruginous sand of the locality. The above substance to 
the amount of two or three pints, was forcibly thrown from the throat : 
then followed viscera, intestines in fragments, making five feet, a small 
heart, liver and trachea, all free from putrefaction or digestive erosion. 
At this stage of the proceedings, I first saw the patient, when she was 



60 Original Communications. [February, 

beginning to produce bones, a few joints of small vertebrae resembling 
the caudal extremity of an eel, ribs, with processes for vertebral articu- 
lation, and osseous union to the sternum, with cartilaginous joint in the 
centre ; also, several pieces of dorsal vertebrae, one having a lumbar and 
sacral termination, and some small bones resembling reptilian extremi- 
ties. The vertebrae amounted to several inches, and were in sections of 
two, three, and four joints, united by some muscular and fibrous tissue, 
bearing the appearance of having been macerated or partially digested. 
As these specimens were produced at intervals of two or three days, and 
twelve or fourteen days had elapsed since the first exhibitions of skin, 
the latter productions evinced more and more the effect of maceration, 
until the last were nearly denuded. The absence of sound information 
in comparative anatomy and reptilian habitudes, together with the pa- 
tient's history, and the testimony of the family, — unimpeachable in vera- 
city, and incapable of collusion,- — gave plausibility to opinions which were 
subsequently disproved. An Irish girl having been in the habit of 
drinking from a running stream at home, becomes sea-sick on the pas- 
sage, feels an epigastric gnawing — one month after her arrival has hys- 
terical convulsions, her first derangement in health; gastric irritation 
increases ; reflexed movements in the voluntary muscles cruelly augment- 
ed ; firm conviction of the existence of a living animal within her, she 
takes the decoction of fern-root ; convulsions are aggravated; the animal 
dies; in six days she begins to eject skin, flesh, viscera, and bones, the 
first not acted on, the last very much so by the gastric fluids. A strong 
coincidence in chronological and physiological appearance. Although 
Ireland is destitute of reptiles in general, the good old Saint has suffered 
one variety of water lizzard to remain, familiarly known as the man- 
keeper, which tradition says is frequently swallowed. When dissatisfied 
with his situation, and the unlucky wight also with his tenant, the latter 
has but to lie down with his mouth near a babbling stream and the rep- 
tile makes his exodus. The text books, after enumerating the parasites 
most common to man, have a stereotyped appendix of accidental occu- 
pants—larvae of flies, triton palustris, lacesta aquatica, salamander, &c, 
and these are so modified by their new situation, as scarcely to be recog- 
nized. 

The lacesta aquatica, like the tadpole, for a period after his escape 
from the ovum, is truly aquatic. He may possibly be swallowed in this 
stage of existence. Vitality, and the active principle of development in 
early life were supposed to be capable of resisting the digestive process. 
JJis small pulmonic, when compared with the systemic artery, proves 



1854.] Coleman— Hysterical Monomania. 61 

him to require a very limited quantity of air for respiration, even less 
than the fishes. The law of adaptation acting so extensively on inferior 
animals might so have changed his habitudes as to enable him to abstract 
a sufficiency of air from the food and saliva. A constantly elevated 
temperature, and abundance of food, might have increased his develop- 
ment even to monstrosity. But the climax exposed the deception by 
producing four entire sections of lumbar and sacral vertebrae, also the 
skeleton and part of the carapace of the land turtle. The artfulness of 
these transactions adds another example to the catalogue of deceptions 
practiced by the hysterical, both upon themselves and their friends. I 
had been present during a number of the paroxysms, had seen her strug* 
gles while extracting the fragments of bone from the throat; the hemor- 
rhage from the fauces, and the concluding convulsions, without detects 
ing the trick, although suspecting the possibility from the first, and ad- 
vising the family to be on their guard for deception. The amount of 
vertebrae thus exhibited is one foot in length. As there is much vague- 
ness in the minds of physicians as to the kinds of parasites capable of 
existing in living animals, I give the remarks of Professor Leidy on the 
subject, who has kindly offered his opinion on this occasion. He says, 
" the bones consist of five or six vertebral columns of young pigeons, 
fragments of cervical vertebrae of the common fowl, and bones of the ex- 
tremities and head, with fragments of the carapace of a turtle. The 
heart and intestines appear to be those of a bird. If the collection were 
vomited from the stomach, it of course must have been previously swal- 
lowed. Independent of the character of the animals to which the differ- 
ent parts in the collection belonged, no animal possessing an osseous 
skeleton is capable of living within the human stomach. Serpents, liz- 
zards, toads, and Salamanders, if swallowed alive, most probably would 
not remain in that condition a single hour; indeed, no animal whatever 
can live within the human alimentary canal except intestinal worms, and 
the larvae of several genera of flies, as the besties or bot-fly, musca or 
flesh-fly, &c. There have been numerous instances recorded of the sup- 
posed existence of eels, serpents, frogs, toads, salamanders, snails, &c. in 
the human stomach, but upon examination they have invariably proved 
to be false/' 

Here is a case of reasoning monomania : the cause of the disease is 
obscure, as the functions of organic life appeared too well performed, but 
its character is unmistakable. The contortions described above, disten- 
tion by flatus, globus hystericus, gastric pains referred to the side des- 
cribed as pathognomonic of hysteria. Pre-disposed to superstition and the 



62 Original Communications. [February, 

marvelous, it is not singular that the idea of a living animal should be 
entertained. Esquirol says, " a weak understanding, hut little or badly 
cultivated, pre-disposes to monomania." The absorbing idea in this case, 
was the reptile, a public declaration of its existence had been made, and 
an honorable obligation required its demonstration. Cunning, so vivid 
in the insane, devised the plan, and reason executed it as by inspiration. 
An ignorant girl, not apparently designing in other respects, conducts 
the scheme with the accuracy of a physiologist, for a time ; thus the ner- 
vous agitation increases in force and frequency for several months — she 
takes medicine ; the paroxysms are exalted ; in thirty-six hours the com- 
motion subsides; teguments are extracted from the throat, apparently 
flesh, viscera, bones, at first covered with tissue, gradually less and less 
so, until they are entirely denuded. Here the judgment failed; too 
great desire for notoriety exposed the trick, but not the manner of it. 
Quadruplicates of entire saeral vertebrae, with the skeleton of a turtle, 
were too much for the largest credulity. 

That much of this material came from the stomach, I have no doubt, 
judging from personal observation and the testimony of witnesses of un- 
doubted sincerity. The ability in some to regurgitate, is great, especial- 
ly when the fauces are titilated. The absurdities of hysterical whims are 
proverbial. When delicately educated females drink their own urine, 
and vomit it up to convey the impression that the renal function is sus- 
pended, and the stomach doing vicarious service ; or when the urethra 
and vagina are filled with pebbles to cheat the Doctor, and the hoax not 
confessed until placed on the table, before a class of students, and tied, 
as for lithotomy, we are not astonished at any report of extravagance. 

Esquirol, again, says, "when monomania does not become chronic it 
frequently terminates spontaneously, with or without sensible crisis/' 
The girl is now well, and unless the violent revulsions so frequently ex- 
cited in the stomach at these exhibitions, modified some existing morbid 
condition of that organ, the cause of recovery is not apparent. Milk is 
no longer relished, and the appetite is good for ordinary food. As this 
case excited much interest in the country, and even among the savans of 
the city, it is offered to give publicity to the declaration of Prof. Leidy, 
"that no animal possessing an osseous skeleton, is capable of living with- 
in the human stomach." 

Pemberton, Jan. 16, 1854. 



1854.] Parrish — Change of Life in Women. 63 

"The Change of Life," in Women; with remarks on the periods 

usually called u Critical." 

By Joseph Parrish, M. D. 

NUMBER II. 

Changes of Childhood— Characteristic Change in the Female— What it is ?— Its 
Office ; the Organs Invoked ; Extent of the Change. 

From the earliest period of infancy, to mature age, there is a constant 
progression in the development of the human organism. There are 
organs, which may be comparatively useless in feeble infancy, that are 
destined in the course of ripening years, to serve essential purposes in 
the human economy; while others are from month to month, and from 
year to year, modified in their capacity, and prepared to perform func- 
tions, which, though similar in kind, differ materially in degree. The 
babe, as it reposes upon its mother's bosom, careless of all surrounding 
objects and influences, is itself a passive being. Its eyes may be open, 
and appreciate the surrounding light, and yet, while the objects within its 
visual range, may be daguerreotyped upon the miniature retina with dis- 
tinctness, there is no evidence of an intelligent impression being trans- 
ferred to the brain. The brain as yet, may be considered a latent organ. 
It is the unpolished plate, waiting for the hand of the artist, to change 
its surface, and fit it for the reception of the impression, already pictured 
within the frame work of the instrument. In the lapse of time, the ce- 
rebral function becomes apparent ; the child evidently exhibits the pheno- 
menon of mental perception ; thought is elaborated, and the period comes, 
when judgment, like a feeble stem, spouts forth, and continues to grow, 
through constantly multiplying changes, till it assumes the type awarded by 
the G-reat Disposer, appropriate to the finite condition of its possessor. 

Again, in the early period of life, the infant is only capable of receiv- 
ing such nutriment, as does not require mastication ; nature has indicated 
this, most certainly, in witholding the teeth from the child, and supplying 
a maternal fountain, equal to its wants. The stomach at this, stage of 
existence, is not capable of appropriating the stronger food, that it will 
afterwards demand as essential to the vigor of the individual. A change 
must be wrought in the organ, to meet the change of circumstances — and 
as it may be matured, the teeth come, and go again, in pairs, the jaws 
widen, and the muscles, covering and moving them, strengthen, so as to 
execute the stern demands of a natural law. As the brain, and its ap- 
pendages connected with vision, so the stomach and its appendages con- 
nected with nutrition, change in their size, capacity, and power, from year 
to year, And as the former may be said to be the centre of the nervous 



64 Original Communications. [February, 

system, and the latter the centre of the nutritive system, there is a cor- 
responding change in the power and susceptibility of the equalizing me- 
dium, exhibited in the nervous arrangement with which they are both 
essentially connected. It is the telegraph by which disorder is announced. 
If the brain, or the nervous system becomes deranged, the stomach, and 
nutritive system feel it, and vice versa : while either, with a powerful re- 
flex action may agitate the whole organism. Hence, the familiar exam- 
ples of disease incident to the period of dentition, the details of which 
it will be needless to enumerate, as the reference here made to the sub- 
ject of early childhood and its changes, is merely for the purpose of af- 
fording an analogy, from which to derive a confirmation of the doctrine, 
presented in the introductory essay — viz : that the " Changes of Life" in 
women are natural, and not to be interfered with, unless some abnormal 
symptoms accompany them. 

The peculiarities of childhood already noticed, are natural to both 
sexes 3 but the first great change to which the human female is subject is 
menstruation. The word menstruation means simply a monthly flow. 
Its etimology does not embrace the character, or quantity of the dis- 
charge, referring only to its periodicity. The organs from which it 
comes, are the uterus and its appendages. Its office, is to transform the 
girl, from girlhood to the estate of a woman. It performs its office by 
developing a latent organ, hitherto inactive, and apparently useless. 
Power is exhibited by the transformation — power to conceive, and to ma- 
ture a living human being. 

The period for the appearance of the menses, called menophania oc- 
curs generally in this climate between the ages of twelve and fourteen 
years. We then have before us at this age of female life, a new organ with 
its appendages, and a new function. To examine them briefly in connec- 
tion with their sympathies and relations, will be the object of this essay. 

A new organ — a womb. For twelve years it has lain in its pelvic bed, 
without alteration, except a very gradual increase of size, to maintain its 
progressive relation with other parts of the economy. A truncated 
conoid body, flattened somewhat upon its surface, nearly an inch in 
thickness, about twice that length, and in breadth, perhaps midway be- 
tween the two. It has a body and a neck, with a slight fissure or cavity 
occupying its interior, and of the same shape, terminating below in a cor- 
responding opening, called its mouth, or os uteri. 

Its appendages — Fallopian tubes, situated above and on either side, 
communicating with the upper angles of the internal cavity, by extreme- 
ly small openings, and extending laterally four or five inches, at firsfc 



1854.] PARRISH — Change of Life in Women. 65 

straight and narrow, but in their course, extremely tortuous, till they 
terminate in a wide fringe, called by anatomists, the fimbriated extremity. 

The ovaries — two ovoid bodies, containing a clear fluid, placed on each 
side of the uterus, and supported by the uterine ligaments, into which 
one of the tendrils of the fringed extremity of the tube before described 
terminate, in order to form a direct communication with the cavity of the 
uterus. 

The vagina — a canal or opening five or six inches in length, embrac- 
ing the neck of the uterus above, and terminating externally. 

These varied, and complicated structures, spring speedily into new life, — 
become sensitive and excitable. The entire system sympathizes with the 
effort, and there is a rapid change in the whole being — a change too fa- 
miliar to need detailed description. 

Consider for a moment, however, the extent of this change. The 
womb, and its immediate tributaries, if T may so call its appendages, are 
not only concerned, but they make a demand upon the heart, and through 
it, upon the entire circulatory system — the spinal marrow, and through 
it the entire nervous structure — the brain, and through it the intellect 
and moral nature, until all are forced into the work. The heart beats 
more vigorously perhaps, and the pulse is more rapid. The nervous 
force is distributed, it may be with some inequality and excitement. The 
brain is more acute, and the moral sensibilities more intense. Such a 
general change in the habits of the constitution, in the character and de- 
velopment of mental phenomena, in the degree, and force of moral im- 
pressions, renders this period one of great interest, while the organs con- 
cerned in this process, are being gradually developed. Their peculiar 
function appears at once — sometimes without premonition. The dis- 
charge often comes on in a moment, or the child may rise from bed in 
the morning, alarmed by the presence of a bloody flow from her body, 
she knows not whence, or how ; and if the general health be good, if her 
mode of life has been natural, if her mind has not been over-taxed, and 
her body subjected to irregular pressure or constraint, it comes even sud- 
denly, without danger — but more of this hereafter. 

What a wonderful provision of nature. It affords to the human female 
a characteristic mark, not known to any other being — a mark distin- 
guished by a sanguineous flow from the uterus, every lunar month, 
which continues from three to six days, and measures in quantity from eight 
to ten ounces. Does it cause the general development of the system, or 
is it the result of growth in the individual ? This is a question unset- 
tled by physiologists : all we can say upon the subject is, that the men- 

«7 



66 Original Communications, [February 

strual development, is coincident with, the general increase of size and 
power in the mental and physical frame — that its occurrence makes an- 
important change in the habitudes of the individual, and that it is a na- 
tural appearance, that it is essential to a healthy condition of mind and 
body. Its sympathies then, are with every part of the human structure, 
"because it maintains a relation to every part : without it, there cannot be 
perfection in development. With it, properly regulated and sustained^ 
there may be a perfect existence. If its appearance is modified by ex- 
cess, or the reverse, there is a corresponding modification in its relatione 
to other organs, its sympathies become morbid, and disease is the result. 
So again, there may be a power over the uterine system, employed by 
morbid changes occurring in other organs : a power sufficient to arrest 
the menstrual flow, to diminish, or to increase it. As has been said al- 
ready, the telegraph by which these sympathies are conducted, is the 
medium of equalizing disturbed and opposing forces ; and if we regard 
not the nervous system in our therapeutic appliances to disorders of men- 
struation, we shall fail to display that tact and wisdom, which should 
ever emanate from, and adorn the medical profession. 

TO BE CONTINUED. 

CORRESPONDENCE. 

American Students in Paris— Hopital La Pitie, it's Origin— Valleix as a Lectnrer— 
Typhoid Fever ; treatment of M. Le Roy by cold water,— frequency of the 
Disease,— Mortality in Parisian Hospitals— Why ?— Bouilland and blood-letting 
in Typhoid Fever— Cholera. 

Paris, December 7th, 1853. 

Messrs. Editors : — It would afford me great pleasure to comply with- 
your request, to contribute something for your valuable periodical,, 
were I perfectly assured that my scribbling might not occupy the place 
of more important matter. But of this you must be the judges. I do 
not flatter myself that I shall be able to speak of anything here, that is 
really new to the well-informed medical men in America. The facilities 
of communication between the two continents, are at present so great 
as to preclude any such idea. Scarcely a day passes without the ar- 
rival of new members of the medical profession from America ; and pro- 
bably every steamer carries home some who have just completed their 
tour of observation and study here. 

You will permit me therefore, to jot down such matters as come under, 
my notice, be they old or new, without wasting time in what at best 
might only be an unsuccessful search, 



1854.] Correspondence. 67 

For some two months past, I have been attending the Clinics, at the 
11 Hopital La Pitie," in the South Eastern part of the city, close beside 
the Jardin des Plantes. It is quite a large Hospital, containing 624 
beds, admitting annually about 11,000 patients. It presents a rather 
weather beaten appearance externally, though not so old as some others. 
It might not be uninteresting to give its origin. 

It seems that at the commencement of the 17th century, the number 
of mendicants became so great in this part of the city, that Louis XIII 
found it necessary to have them confined; for this purpose the grounds 
where the Hospital stands were obtained, and buildings erected in 1612, 
and named the Hopital de La Pitie. 

At first it was simply a receptacle for old mendicants of the male sex, 
but, after the building of the large Hospital "Salpetriere" by Louis XIV, 
(which at present contains some 3000 people,) they were all removed 
thence, and La Pitie became a refuge for orphans and destitute 
children. During the revolution, these were named the " Children of 
the Country." It was not until 1809, that La Pitie became a regular 
Hospital for the sick. If this sketch should be deemed malapropos, I 
may remark that the old Hospitals here have distinct reputations. Vel= 
peau for example, is called the distinguished Surgeon of La Charite, and 
in some diseases, "La Charite" has a treatment of its own, known as the 
" Treatment of La Charite." 

La Pitie has always sustained a good reputation. Lisfranc was 
Surgeon there for many years, contemporaneously with Dupuytren 
at Hotel Dieu, and acquired a celebrity second only to his. I find he 
is very often quoted. In the medical department, I may mention Dr. 
G-endrin, a fine old man, still at his post, who will lecture on Cholera in 
a few days. 

But I wish more particularly to speak of Dr. F. L. I. Valleix, 
whose course I am now following. I have not been able to find a better 
medical clinic any where in Paris. He has charge of about 90 patients, 
one half of whom are women. He usually spends about three hours in 
the wards, every morning, except the mornings that he lectures, which 
is every other day. In most cases of importance, he allows the " ex- 
ternes," or any one that chooses, to come forward, and examine patients 
who have recently entered the Hospital, requiring them to give their di- 
agnosis, prognosis and treatment, and at the close mentioning whatever 
may strike them as remarkable in the case. Valleix then points out 
what he deems to be faults in the manner of examination, — retraverses 
&he whole case himself, making a thorough exploration of all the impor- 



68 Original Communications. [February, 

tant organs by means of auscultation, percussion, palpation, &c, interro- 
gating all the functions, no matter what the case may be — in short 
leaving no means untried to bring out all the lurking symptoms of dis- 
ease. He then describes the case as he finds it. And as the symptoms 
generally point toward some three or four diseases, he proceeds to make 
the " differential" diagnosis, which, according to the French practice, is 
always by way of exclusion-— throwing out first the most improbable, 
then the next, and so on, till he brings it down to a point, and the diag- 
nosis is made, with so much rigor and exactness, and at the same time, such 
a comprehensive survey of the whole case, that one feels that the "force 
of science could no farther go," at least in its present state. When there 
is still a doubt, of course it is necessary to await the progress of the dis- 
ease, or the demonstrations of the autopsy room. I have known him to 
spend an hour on one case in this way — and I always considered the 
hour very profitably spent in listening, though it must require no small 
amount of patience for him ; but being an enthusiast as he is in his pro- 
fession, the labor does not appear onerous. 

He has been testing for some time past, the treatment of M. Leroy, 
in Typhoid Fever, which has been epidemic in Paris for almost twelve 
months. The principal peculiarity of it, consists in requiring the patient 
to drink copiously of cold water, and keeping cold compresses applied to 
the abdomen, renewing them every fifteen minutes or half hour. Bleed- 
ing once or twice at the commencement, if the fever be very high. M. 
Leroy, according to his statements, has had remarkable success. The 
results with M. Valleix have not been so successful, though he admits 
that he has not been able to give it a fair trial, as it is impossible in a 
Hospital, to have the compresses renewed as often as required. Yet still, 
his experiments have shown : — 1st. That the tongue, mouth, and mu- 
cous membrane are kept in better condition in this way, than in other 
modes of treatment. 2d, That there is not so much liability to severe 
ulcerations or perforation of the intestines, and that the skin remains 
more cool and moist. It will be seen at once, that this is only one mo- 
dification of Hydropathic treatment, And I may remark, that I have 
known Professor Tousseau resort to cold affusions in apparently desperate 
cases of this disease, with the most marked success ; but he thinks they 
are particularly beneficial in the ataxic form of the fever. Dr. Gendrin 
of La Pitie, has used water in this disease for many years. There -is a 
great amount of Typhoid Fever here, and the fatality is very great. Pro- 
bably an average of the statistics would give one death in every seven 
cases, some say one fourth, and some one tenth. But this is almost 



1854.] Correspondence. 69 

equally true of other diseases, for of the thousands who enter the nume- 
rous Hospitals of Paris every year, statistics show that one-tenth never 
come out alive, I am not familiar with the statistics of the Hospitals of 
the United States or Great Britain, but I have no idea that they tell so 
badly as this. I heard Prof. Nelaton say the other morning, that it had 
become a moral question with him, whether he ought to perform the ope- 
ration of amputation of the leg or thigh at all, for, of all of the amputations 
performed at this Hospital, (La Clinique) there have been but two cures; 
all the rest have died, and generally of purulent absorption. And he 
would not have it understood that this Hospital was peculiar in this re- 
spect, — all the other Surgical Clinics of Paris gave the same result. This 
frightful mortality he said demanded a complete reform in the manage- 
ment of Hospitals. To what it was to be attributed he did not say : — 
certainly not to the manner in which the operations are performed. The 
debilitated condition of the patients when they enter, resulting from bad 
air, bad lodging and insufficient nourishment, is no doubt one great cause. 

Then their manner of dressing is objected to by some. They have a 
material called " charpie," which is simply a coarse lint : they place this 
around the wound in great abundance, so that the limb is deeply buried 
in it, securing it with cloths and bandages. This exceedingly heavy 
dressing, would certainly seem to favor inflammation, and purulent ab- 
sorption might be accounted for, by the general anaemic condition of the 
patients. Nevertheless Parisian patients seem to support bleeding better 
than in our climate. Prof. Bouillaud treats Typhoid Fever by his favo- 
rite practice of bleeding " coup sur coup," or repeatedly, and at short in- 
tervals, and they are said to do well ; of course he says better than under 
any other treatment. However, he is in the minority in this opinion, yet it 
is certainly astonishing how well they do ; his cures seem to be about the 
same as others, though the term of convalescence is much prolonged. I 
simply give this as a curious fact I presume few Americans would feel 
disposed to bleed as heorically as Prof. Bouillaud. 

I had intended to speak of M. Valleix's treatment of uterine displace- 
ments, and his modifications of the uterine sound, and redresser of Dr. 
Simpson, but if you will excuse this desultory letter, I will make that 
the subject of another paper. I will conclude by stating, that Cholera 
is upon us; there are cases entering the Hospitals every day, the most of 
whom die. It has not spread very much as yet. It seemed almost 
to have died out a little more than a week ago, but burst out again 
worse than ever, Twelve cases entered Hotel Dieu, before noon day be- 
fore yesterday. There is no certainty that Paris may not soon be a prey 



70 Original Communications. [February, 

to the scourge. A singular case occurred at "La Charite." — A matron 
of one of the wards, in passing a cholera patient, spoke to the servant and 
told him to be careful and see that patient well attended to, as he had the 
Cholera. Whereupon the man fainted upon the spot, — was carried out 
of the ward, — and in less than twenty-four hours died of Cholera. He 
had not complained before. 

Very respectfully yours, B. 



Imperial Academy of Medicine— description of its Halls— Session of the 
Academy— Report on the Treatment of Aneurism by Injections of Per- 
chloride of Iron— Discussion— Interest in the Proceedings, on the part of 
the Members. 

Paris, Thursday, November 17, 1853. 

Dr. Isaac Wood — Although I have not attended a meeting of 
our Academy for nearly two years, yet I continue to feel a deep 
interest in its welfare, and shall be happy if, in any way during my 
residence in this metropolis, I can advance its interests. As many of the 
Fellows have not had an opportunity of attending the meetings of our 
great prototype, the Imperial Academy of Medicine, I have thought it 
might be interesting to them to give a hasty sketch of the meetings held 
on the 9th and 16th of November, at 4 P. M. We enter by a side door 
into the ancient chapel of La Charite Hospital, (Rue de Saints Peres.) 
The vestibule, or porch is a square room with a colossal statue of iEscu- 
LAPius at its upper extremity, flanked by marble busts of Baron Percy 
and Portal. Around the walls are ranged busts of Beclard, Chaus* 
sier, Pinel, Scarpa, Fouquier, G-uersant, Larrey, Panset, Mar- 
jolin and Dupuytren — the two latter in bronze. The Salle des Sean- 
ces is a small room, but little more spacious than our small chapel of the 
University, lighted by a sky light, and badly ventilated. Each member, 
as he passes in, inscribes his name on the Register, which thus becomes 
a most interesting collection of autographs. Over the President's chair 
is a picture, after Rembrandt's, representing "Tulpitjs demonstrating 
the flexor muscles of the fore arm." Around the room are suspended 
twelve portraits of the illustrious members of the Academy — the most 
conspicuous among them being those of Boyer and Orfila in his scar- 
let robes of office. In the niches above, in gilt letters, are the names of 
distinguished physicians on one side, and of surgeons on the other — all 
of whom have been members of the Academy, and are deceased. A small 
pulpit is in front of the speaker's table, called the tribune, which is oc- 
cupied by those who take part in the discussions, and who remain seated 
while so engaged. On the desk, before each member, is pen, ink, and 
paper. 

It is ten minutes past three. About 60 are present, many of them in 
advanced years. The Vice President, Macquart, (an aged man who has 
lost his teeth and power of distinct articulation,) takes his seat, rings his 



1854.} Correspondence, 71 

bell and calls for the reading of the minutes. The Secretary, M. Gibert, 
reads a sketch of the proceedings of the last meeting. The Perpetual 
Secretary, M. Dubois D'amiens, then reads the foregoing domestic cor- 
respondence, exhibits instruments or apparatus which may have been 
sent in, acknowledges the receipt of communications, donations, &c. If 
there be any communication of importance, he moves the appointment of 
a Special Committee. If any member has a morbid specimen to exhibit, 
it is presented and commented on at this time. The Academy is now 
ready for the Reports of Special Committees. M. Malgaigne, Chair- 
man of a Committee appointed to report on the treatment of aneurism 
by the injection of per chloride of iron, with a view to the coagulation of 
the blood in the aneurismal sac, the quantity to be proportioned to the 
size of the tumor. By injecting too much, violent inflammation might 
be excited — then, ulceration and the expulsion of the clot. For an aneu- 
rism of the size of a pigeon's egg, 4 or 5 drops will suffice, and the injec- 
tion to be repeated, if, at the end of a certain time, the pulsations have 
not entirely ceased. Experiments upon horses and sheep had been suc- 
cessful in producing coagulation, 

The report occupied about half an hour in reading, and was listened 
to with great attention. All the cases in which this method had been 
adopted, were embodied in the report, with the result, that of 11 cases, 4 
died, and in the greater part of the rest, symptoms more or less severe, 
with the necessity of recourse to the ligature. The conclusions of the re- 
port were, "That this method is less dangerous in varices than in aneu- 
rism, and that time alone can determine the validity of the cures alrea- 
dy attained. That in aneurisms, although the possibility of cure by in- 
jections may be placed beyond a doubt, yet the cures have been so few, 
accompanied by such grave symptoms, and counterbalanced by so great 
a number of reverses, and even deaths, that in the present state of our 
knowledge, we think that no prudent surgeon would expose his patient 
to a mode of treatment so disastrous." 

Discussion. — M. Moreau, in a general way, protested against experi- 
menting upon the human subject. M. Roux, though agreeing with M. 
Malgaigne in his conclusions, still thought it imprudent to prejudge 
this method or condemn it; was disposed to adopt John Hunter's me- 
thod as the most complete triumph of surgery. It appeared to M. Roux, 
that in popliteal aneurisms, it was desirable to discover some other method 
than the ligature. M. Velpeau claimed for Anel the method by lig- 
ature, and not for Hunter, agreed with M. Malgaigne in his conclu- 
sion, and objected to Pravaz' method on account of the insolubility of 
the clot, which thus became a source of inflammation, and acted, when 
of considerable size, as a foreign body. M. Laugier regretted that M. 
Malgaigne had not spoken of the action of perchloride of iron upon va- 
rices and erectile tumors, and called attention to the unfortunate results 
in the experience of Sir Wm. Lawrence. M. Soule', (of Bordeaux,) in- 
sists upon two sorts of accidents produced by this agent \ gangrene of the 
part by the sudden interruption of the circulation, and the perforation of 
the walls of the sac, in consequence of inflammation or gangrene, 



72 Original Communications. [February, 

The hour for adjournment, 5 P. M., having arrived, the discussion 
was postponed until the next meeting. 

Session of 15th November. — After the reading of minutes and 
correspondence, M. De Paul exhibited a specimen of Extrophy of the 
Bladder with bifid uterus and other anomalies. The discussion on injec- 
tions of perchloride of iron was continued by MM. Velpeau and Le 
Blanc. M. Velpeau was unwilling to despair entirely of this method, 
but hoped that some means would be devised either for using some less 
irritating solution or modifying the mode of operation. M. Le Blanc, 
(Veterinary Surgeon) recited experiments made by himself and others, 
upon animals, and reported a new case of aneurism at the bend of the 
elbow, treated at Lyons with complete success by Dr. Valette. M. Le 
Boy d'Etoilles presented a letter on the subject. After the discussion 
had concluded a new stethoscope was presented by Gtroud, which was 
referred to by M. Piorry. 

I have thus endeavored to present a succinct sketch of the proceed- 
ings of the Academy; its meetings are always full, and even its extra 
sessions — twice in one week sometimes. M. Chomel, remarked to me, 
" I always wish to attend the meetings of the Academy, and I always 
endeavor to do so." I should like to go into the history, and give you 
the present organization of the Academy, but time will not permit. The 
number of members is limited to one hundred, and the admission is by 
concours. Several of the members have spoken in high terms of the New 
York Academy of Medicine, and I know that it is looked to as the organ 
of the profession in the United States. Would it not be well to send a 
complete set of all our publications to the Perpetual Secretary, M. Du- 
bois d' Amiens ? I shall remain here until the 15th December, and will 
see that they are presented, if sent by that time per Franklin. 

Professor Brainard, of Chicago, is now experimenting upon animals 
with another preparation of iron, with a view to preparing a paper on 
the " Treatment of Aneurisms," to be read before the Academy. He re- 
ports several successful cases. The use of chloroform has been very fully 
discussed in the Medico Chirurgical Society of Paris. [M. Bobert, Be- 
porter, recommends its use in preference to other anaesthetics, except in 
certain cases.] The son of M. LeBoy d'Etoilles has just received the 
prize of 1,000 francs from the Academy. 

With great respect, truly yours, 

JOHN a. ADAMS. 



PROCEEDINGS OF MEDICAL SOCIETIES. 

District Medical Society for the County of Burlington. — The annual 
meeting of the District Medical Society for the county of Burlington, 
was held at the house of B. S. Humphrey, in Mount Holly, on Tuesday, 
January 11, 1854. 

Members present— Dr. Butler, president; Drs. Stratton ? Zachariah 



1854.] Proceedings of Medical Societies. 73 

Read, A. Reid, Coleman, Woolston, A. E. Budd, Trimble, Elwell, 
Challiss, Martin, Longstreet, Young, Bryan and Gauntt. 

The minutes of the last meeting were read amended and adopted. 

Dr. S. C Thornton, Jr., of Moorestown, Dr. George Goodell, of Platts- 
burg, and Dr. E. R. Denby of Mount Holly were proprosed for member- 
ship. Dr. Denby was present, and invited to take a seat in the Society. 
Dr. S. C. Thornton, Sen., of Moorestown, was also invited to take a seat 
in the Society. 

The preamble and resolutions respecting the collection of fees, which 
were offered at the last meeting, and laid over for final action at this, 
were read, discussed, and the second resolution amended so as to read thus. 

Resolved, That after the first of January, 1854, the physicians of this 
county will consider their bills due at the termination of each individual 
case of sickness, and will present them at that time, or within one month. 

Resolved, That the preamble and resolutions be published three times, 
in each of the newspapers of this county. 

On motion, Resolved, That the preamble and resolutions be laid before 
the State Society by our delegates, and that the Secretary furnish them 
with a copy for that purpose. 

Dr. Bryan read a communication before the Society on Apoplexy, with 
a description of the autopsia, for which the thanks of the Society were 
returned, and a copy requested for publication. 

Dr. Woolston reported some cases of subcutaneous vaccination, which 
had fallen under his notice during the past few years, and which he 
thought of sufficient importance to demand the attention of the Profes- 
sion. Dr. W. has contrived an instrument for the purpose of producing 
this species of vaccination, and he was requested to draw up a statement 
of his experience, &c, on the subject, with a description of his instru- 
ment, for the pages of the Reporter. 

Dr. Coleman read an essay on Hysterical Monomania, for which 
he was thanked by the Society, and a copy requested for publication in 
the New Jersey Medical Reporter. 

The President, Dr. Butler, read an able and very interesting address, 
for which the Society returned their thanks, and requested a copy for 
publication, and ordered that it should be copied into the Secretary's book. 

The following named were duly elected officers of the Society for the 
ensuing year. 

President, Dr. R. H. Page ; Vice President, D. B. Trimble ; Trea- 
surer, B. H. Stratton ; Secretary, F. Gauntt. 

Drs. I. P. Coleman, Bryan, Elwell, and Young were elected delegates 
to the State Medical Society for the ensuing year, with power to fill 
vacancies or appoint alternates. 

Puerperal Fever was proposed as the subject for discussion at the next 
meeting, and Dr. Z. Read was appointed essayist. 

Drs. Longstreet and Bryan were appointed a committee to examine the 
Treasurer's accounts. 

Adjourned to meet at the house of S. B. Campion, on the 2d Tuesday 
in April next. 

10 FRANKLIN GAUNTT, Sec'y, 



74 Editorial. [February, 

EDITORIAL, 



CHANGE IN THE EDITORSHIP.— REMOVAL. 

la consequence of our arrangements, to move to Philadelphia, the 
name of S. W. Butler, M. D,, appears for the first time upon the title 
page of our present issue, as Editor. In looking forward to this change, 
the fact of severing our connection with the profession of New Jersey, 
has, indeed, been marked with feelings of sincere regret. And in relin- 
quishing the editorial charge of the organ of its State Society, we are 
happy to leave the work in the hands of one, who has proved himself 
worthy of the confidence and gratitude of the profession, by his unwea- 
ried toil as publisher. 

As he has succeeded in this department, so far beyond the expecta- 
tions of the friends of the Reporter, we hope he may excel in the 
editorship. And while we may continue our interest in the work, as an 
Associate, we bespeak for the new editor, a hearty support from the pro- 
fession. We have been engaged in it for the last six years : much of the 
labor of writing and revision that has fallen to our lot, during that time, 
has been performed in the houses of patients, where duty has called us, 
either in the vigils of the night, or in the watching hours of the day, 
and sometimes in the abodes of poverty, under circumstances the most 
unfavorable for such pursuits; hence many of the imperfections that are 
apparent in our contributions. The work, however, though feebly be- 
gun and inefficiently executed, has, we trust, been of some service to the 
medical profession of the State. Its aim has been to do good — if we 
could believe that it has failed entirely to accomplish its end, we should 
hardly be willing to say farewell, but would rather take a hasty " French 
leave/' 

If it has done no more, it has laid the foundation of New Jersey me- 
dical literature, and upon this, there may rise,- — we hope there will, — a 
noble, and enduring superstructure that may adorn the profession, and 
honor the State. In conclusion we must say, that our relation to the 
profession of New Jersey, has been in a high degree satisfactory, and 
beneficial ; and our intercourse with its members, pleasing and fraternal. 
As we shall carry with us to our new home, the fruits of a hard- 
earned experience in medicine, we shall often look back to the field of 
our early labors, and enjoy the reflection that in this good old State 



1854.] Editorial 75 

there are hundreds of friends, with whom we have mingled, in our va- 
rious benevolent, and scientific associations, and that not a shadow of un- 
kindness has been cast upon our fraternal intercourse. With such feelings, 
we must bid the profession of New Jersey, and our readers everywhere, 
a hearty, and sincere fare -well. We would that in their organizations for 
self-improvement and the general good, they may act still more nobly in 
the future, than they have in the past. We would that in their private 
relations, honest and faithful labor in the chambers of disease, may be 
rewarded by the unfailing confidence of the people, and our noble profes- 
sion be exalted to the point to which it is destined, if its votaries prove 
to be faithful and true. JOSEPH PARRISH. 

SALUTATORY. 

The above announcement from the former editor of this Journal, calls 
for a few words from the undersigned. Our pen is not equal to the task 
of describing the feelings with which we indite these remarks. In view 
of the important and prominent position, which, by an overruling Pro- 
vidence, he is called to occupy, and in comparing it with his past career, 
and former hopes and aspirations, the subscriber feels that he would be 
recreant to duty, and unworthy the high trust reposed in him, weie he 
to fail to record here, his sense of gratitude, — first, to the God of his fa- 
thers, through whose unmerited goodness, he has thus far been prosper- 
ed in all the labors of his hands, — second, to those friends of his earlier 
years, who, while he was struggling with poverty, stood by him, and en- 
couraged him in his onward course, — third, to the members of the me- 
dical profession, from whom on all sides, he has during his brief profes- 
sional career, received distinguished marks of consideration, — and lastly, 
to the public, from whom in the social circle, and in the business walks 
of life, he has ever received the encouraging smile, and the helping hand. 

Promises, the subscriber has none to make. If in his hands the New 
Jersey Medical Reporter shall continue to be as worthy the sup- 
port of the profession, as it has been under the editorial conduct of 
his predecessor, he will confidently expect that support, and in this con- 
fidence, he will avail himself of every means to increase its usefulness. 

In conclusion, the subscriber congratulates both himself and the read- 
ers of the Reporter, that the services, counsel, and advice of the for- 
mer editor will be retained, and that in addition to it, he will also have 
those of Henry S. Patterson, M. D., of Philadelphia, who, though weak 
in body, from chronic disease, has yet an untrammelled mind, active, and 
desirous as ever of advancing the interests of a profession he has so long 



76 Editorial. [February. 

loved and honored . His inability to attend to the active, out-door duties 
of his profession, leaves him at leisure for literary pursuits, and we are glad 
that his mental energies are enlisted in the cause of the medical periodi- 
cal literature of our country. 

Under such auspices, and with such prospects, the undersigned throws 
himself upon the profession, assured, from past experience, that full jus- 
tice will be done him, by all with whom, in his editorial and business 

relations, he is brought into contact. 

S. W. Butler. 

ASTOR LIBRARY. 

The opening of this magnificent library in the city of New York, on 
the 9th of January, forms an important era in the history of literature^ 
in our country. The following extract relating to the Medical depart- 
ment of the library, is taken from a descriptive letter of its able super- 
intendent, Rev. Dr. Cogswell, — published in the Home Journal. 

" The number of volumes in the Medical Department of the Library is only 1751„ 
This, as a specialty, is so well provided for in the Hospital, and other medical libra* 
ries of the city, it was thought less important to make a full collection of medical books 
here. It is also a specialty in which there are many books not suited to a general 
public library. Medical advisers were necessary to aid in making a proper selection, 
and though often invited, they would not come to the consultation, possibly, because 
the fee was not tendered. Still, full justice will be done for the department, when it 
is known what should be done ; medical gentlemen have only to say what books are 
wanting, to be sure of their being provided." 

It was in the office of the Rev. Dr. Cogswell, while one of the editors 
of the "New York Review," that the writer, then a lad, first began to 
feast his appetite with unsatisfying draughts from the sea of literature. 
Yet, with all the respect due an old preceptor, we cannot sit silent under 
the imputations which, in the above extract are cast upon a profession, 
to which we have devoted our life and energies. 

The excuse (it is very far from being a reason,^) which he gives, for 
neglecting the medical department of the library, betrays a want of inte- 
rest in that department, which is but ill concealed under the ungenerous 
and sweeping charge he has made against the profession of New York. 
We are loth to believe that any of our brethren in New York who are 
worthy of the name of physicians, would refuse their advice in so impor- 
tant a matter, simply because no fee was tendered ; and we think that 
Dr. Cogswell might have made a more charitable supposition than he did. 

At any rate, let our New York brethren come forward, and respond to 
the invitation given in the closing part of the quotation, by a competent 
committee from the Academy of Medicine, or from the county Medical 
Society > and let there be in the Astor Library a collection of medical 
authorities, worthy of the profession of the metropolis of America, 



1854.] Editorial. 77 

SUBCUTANEOUS VACCINATION. 

By reference to the proceedings of the District Medical Society for the 
County of Burlington, it will be seen that Dr. Samuel Woolston of Vin- 
centown has been experimenting in vaccination. By means of an instru- 
ment of peculiar construction, in part we believe of his own contrivance, 
he inserts the vaccine virus under the cutis vera, and the puncture, heal- 
ing by the first intention, the matter is left entirely beneath the surface 
of the skin, where the vaccine sore forms, passes through its regular 
stages, having the appearance of an abscess beneath the surface of the 
skin, which is ultimately absorbed, and disappears, without any external 
sore whatever. Whether by this method of vaccination the protection 
against variola would be more perfect than by the common mode, we are 
not prepared to say, but should suppose that it would. The symptomatic 
fever, when the inflammation is at its height, and while the absorption 
of the pus is going on, is more marked than in the ordinary mode of vac- 
cination. When the operation is performed in this way, the physician will 
have to furnish the patient with a certificate of vaccination, as no cicatrix 
is left as evidence that it has been performed. We hope that Dr. W. 
will pursue his investigations, and report his conclusions on the subject. 

STATE MEDICAL SOCIETY. 

The Medical Society of New Jersey held its eighty-eighth annual 
meeting at Trenton, on the 24th and 25th ult. The gathering of mem- 
bers of the profession from all parts of the State was respectable, and the 
proceedings were full of interest. 

As, however, the minutes and reports will be published in full, in our 
next issue, we refrain from further remark in this place. 

To our readers generally, we would say, that the proceedings of our 
State Medical Society, are published as extra matter ', not encroaching, in 
the least, on the ordinary size of the Reporter. 

THE BIBLIOGRAPHICAL DEPARTMENT 

Of this journal, which will be under the special supervision of Dr, 
Patterson, will receive particular attention. 

Having completed arrangements by which we shall get early informa- 
tion of all works on medicine and the collateral sciences, about to be issued 
from the press, both of this country and Europe, we shall, as occasion re- 
quires, furnish our readers with a Record of works in press, which, we 
believe, will be of advantage to them. 



78 Editorial. [February, 

Our Book Notices, will, as heretofore, be impartial and comprehen- 
sive, — not mere advertisements, but fair and trustworthy exponents of 
the real worth of the works noticed. 

Publishers will forward to the Editor at Burlington, or to our 
agents as indicated on the title page of cover. 

AMERICAN MEDICAL ASSOCIATION. 

We are happy to say that the able historical articles on the history 
of this Association, the second of which appears in the present number, 
are receiving the attention they merit. We expect to have the portrait 
of the second president, — the late Dr. Nathaniel Chapman of Philadel- 
phia, — ready for our next issue. 

OUR FOREIGN CORRESPONDENCE. 

We have several correspondents abroad, from whom we expect, from 
time to time to receive letters of interest to our readers. We present two 
very interesting letters in this number, from Paris ; the first, from our 
regular correspondent, and the other copied from the pages of the New 
York Daily Times. It treats of a subject of sufficient interest for per- 
manent preservation. 

From the communication of our regular correspondent it will be seen 
that Cholera is decidedly on the increase in Paris. 

We find ourselves again overcrowded with material. Several pages of 
matter, besides communications, a part of which was prepared for the 
last issue must lie over. We shall, if necessary, relieve ourselves, by the 
addition of extra pages from time to time. 

EDITOR'S TABLE, 

A Lecture by Jonathan Knight, M. D., Introductory to the Course of 
Lectures in the Medical Institution of Yale College. Sept. 29, 1853. 
In this lecture we notice : — 

1. That the Medical Institution of Yale College is the fifth in the U. 
States as respects age, having commenced its first course of lectures in 
November 1813. The four schools that preceded it were, one each, in 
Philadelphia, New York, and Boston, and one at Hanover, N. H. ,2. 
That the first year the session continued from the 1st of Nov. to the 1st 
of May. Afterwards, for several years, they were five months in length, 
and were finally reduced to four months as at present. 3. The great- 
length of time the several professors have maintained their connection 



1854.] Editors' Table. 79 

with the school,— with three of them extending to forty years. Only 
eleven persons have held professorships in the school — but three resigna- 
tions have taken place, two of them very recently, from advanced age, 
and but two vacancies have been caused by the death of the incumbents. 
4. Nearly one thousand physicians have been introduced into practice 
from the school, eleven of whom have been appointed professors in other 
medical schools ; two have been selected to take charge of public Lunatic 
Asylums, and several others have been connected with such institutions; 
five or six have been appointed medical missionaries in foreign fields, 
where they have become highly useful and distinguished. 

This school has been little, if any, influenced by the reprehensible 
*' tricks of trade," by which we are sorry to say, too many schools endea- 
vor to swell their numbers. Long may it thrive, and occupy an honor- 
ed place among its fellows ! 

Seventeenth Annual Report of the Trustees and Superintendant of 
the Vermont Asylum for the Insane.— -"Since the opening of the Asylum 
2066 patients have been admitted, 1694 have been discharged, and 372 
remain in the Institution, Aug. 1—1853. Of the 1694 who have been 
discharged, 968 have recovered, equal to 57.14 per cent. Of those 
placed in the Asylum within six months from the attack nearly nine- 
tenths having recovered." 

"During the past year 510 have enjoyed the benefits of this institu- 
tion — 851 remained, at the commencement of the year, 159 have been 
admitted, 138 have been discharged, and 372 now remain. Of those 
discharged 72 have recovered." 

The expenditures of the Institution exceeded the receipts by only 
$1,574,45. We believe this is the first institution of the kind, the in- 
mates of which undertook to edit a paper. The effort was eminently suc- 
cessful, but we do not know whether its publication is continued. 

The Medical Chronicle, or Montreal Monthly Journal of Medicine and 
Surgery. Edited by William Wright, M. D., and D. C McCallum, 
M. D., Montreal, 1859, pp. 32. Before us is number 7 of volume 1, 
of the above work, which is designed to fill the blank occasioned by the 
failure of the Canada Journal of Medicine, &c. We hope the present effort 
to establish a medical periodical in Montreal will be more successful than 
the two preceeding ones. The Chronicle seems to be worthy of a hearty 
support. Cannot the editors forward us the six preceding numbers that 
our volume may be complete ? 

On the Treatment of Vesico-vaginal Fistula, by S. Marion Sims, 
M. D., (late of Montgomery, Alabama.) Many of our readers may re- 
member to have seen the paper, of which this a reprint in the Am. 
Journ. of Med. Sciences for Jan. 1852. The object of the republication 
seems to be for the purpose of announcing to the profession, that being 
obliged, on account of ill health, to forsake the South, he has located him- 
self in New York, where he has opened an Infirmary for the special treat- 
ment of the accidents of parturition, such as injuries of the bladder, rec- 
turn, perineum, &c. 



SO Editorial. [February, 1854.] 

NECROLOGICAL RECORD. 

Died— -in New Orleans, Dec. 1, of Cholera, A. Hester, M. D., Editor of the N. O. 
Medical and Surgical Journal. 

In New York, Dec. 7, Thos. G. Mower, M. D., U. S. A. 

In Philadelphia, Dec. 15, of Hemorrhage from the lungs, John A. Elkinton, 

M. D. Dr. E. had been been an efficient member of the Board of Health, and was, at 
the time of his decease an Alderman of the city. 

At Baton Rouge, Louisiana, on the 27th Sept., of Yellow Fever, Dr. John G. 

Ludlow, son of Rev. Gabriel Ludlow, of Neshanic, New Jersey. 

In Templeton, Mass., Dec. 9, Mason Spooner, M. D., in his 82d year. Dr. S. 

had, for sixty years been a practitioner of medicine, and was highly respected for his 
virtues and general attainments. 

In Dinwiddie Co.,Va., Dec. 15— Robert E. Wall, M. D., U. S. A. 

In Boston, Dec. 20— by suicide, Josiah E. Flagg, M. D., a celebrated dentist. 

His death was said to have been caused by insanity, consequent on the spiritual rap- 
ping delusion. 

In Philadelphia, Jan. 23— R. M. Bird, M. D., one of the Editors of the North 

American ; a talented man, and vigorous writer. 

At Tunis, Barbary, Oct. 2, 1853— Samuel D. Heap, M. D., U. S. Consul at that 

place. Dr. H. was a native of Carlisle, Pa., but has been in government service, first 
as Surgeon in the Navy, and afterwards in various other offices both at home and 
abroad, since 1804. 

In Philadelphia, Jan. 4th, Samuel McClellan, M. D., in the 54th year of his 

age. (A biographical notice of Dr. McC, will appear in our next.) . 

The Seventh Annual Meeting of the American Medical Association, will be held 
in the city of St. Louis, on Tuesday, May 2d, 1854. 

The Secretaries of all societies, and all other bodies entitled to representation in the 
association, are requested to forward to the undersigned correct lists of their respec- 
tive delegations, as soon as they may be appointed; and it is earnestly desired by the 
committee of arrangements, that the appointments be made at as early a period as 
possible. 

" Each local society shall have the privilege of sending to the association one dele- 
gate for every ten of its regular resident members, and one for every additional frac- 
tion of more than half this number. The faculty of every regularly constituted Medi- 
cal College, or chartered school of medicine, shall have the privilege of sending two 
delegates. The professional staff of every chartered or municipal hospital, contain- 
ing a hundred inmates or more, shall have the privilege of sending two delegates ; 
and every other permanently organized medical institution, of good standing, shall 
have the privilege of sending one delegate. 

" Delegates representing the medical staffs of the United States' Army and Navy, 
shall be appointed by the chiefs of the army and navy medical bureaux. The num- 
ber of delegates so appointed, shall be four from the army medical officers, and an 
equal number from the navy medical officers." 

The latter clause in relation to delegates from the army and navy, was adopted as 
an amendment to the constitution, at the last annual meeting of the association, held 
in New York, in May, 1853. E. S. LEMOINE, 

One of the Secretaries, St. Louis. 

The medical press of the U. States is respectfully requested to copy the foregoing. 



THE 

NEW JEBSEY MEDICAL BEPOBTEB. 

VOL VII. M A R C H , 1 8 5 4 . NO. III. 

Thoughts on retention of the Placenta from irregular Uterine Contraction. 

By William Johnson, M. D. 

The placenta may be retained in utero from inertia of tjie organ, or 
from adhesion between it and the uterus, or from irregular contraction. 
It is to the last of these causes that I woujd at present direct attention. 
Irregular uterine contraction may manifest itself in a variety of ways. 
One of its most frequent forms is that in which tjie longitudinal muscu- 
lar fibres of the organ are inactive, whilst the circular fibres are acting 
vigorously, thus compressing the placenta into an oblong sliape ; and this 
form of abnormal contraction, is frequently complicated by fasciculi of 
muscular fibres contracting upon a portion of the placenta, so as to pro- 
duce a cornu, effectually preventing the expulsion of this body. Ano- 
ther form of irregular contraction is that of the sugar loaf; fasciculi of 
muscular fibres contract upon the placenta so as to give the uterus this 
shape. Another, but less frequent form of irregular uterine contraction, 
is found in the hour-glass uterus. Obstetrical practitioners engaged in 
large business, have not very frequently observed this variety. Rams- 
botham, whose opportunities for observation were as great as almost any 
other practitioner, says, that of the many cases of retained placenta which 
he has been called upon to remove, he has met with but three or four 
.cases of complete hour-glass contraction. It has been my hap, although 
engaged in a much smaller practice, to have encountered as many as this 
number. By hour-glass uterus, is to be understood that form of irregular 
contraction in which the organ is divided into two compartments by the 
firm contraction of a band of circular fibres about its middle. Burns con- 
founds this with all the other varieties, and makes it a circumstance of 
frequent occurrence. Another form of irregular contraction is the glob- 
ular ) the placenta becomes encysted by the strong contractions of the 

circular fibres of the cervix uteri, Several other forms of irregular con- 
11 



82 Original Communications. [March, 

traction of the uterus might be mentioned, but the foregoing subserve 
my purpose. In all these ways the placenta is imprisoned in the uterus, 
and nothing but the interference of art can liberate it. 

Every such case proves a source of vexation, both to the accoucheur 
and to the patient. The latter has her raised expectations sadly disap- 
pointed, and her cup filled with delight, in the realization of being a mo- 
ther, is dashed from her lips ; and the former feels a kind of repugnance 
to the adoption of the only means of removing the difficulty, viz : the 
introduction of the hand, dilatation of the stricture, and the removal of 
the placenta. 

The supervention of this accident may always be suspected, when, af- 
ter the expulsion of the child, we find unusual difficulty in reaching the 
placenta with the finger, and at the same time feel the womb firmly con- 
tracted, by the hand placed on the abdomen of the patient; and especial- 
ly if with these circumstances, there be too profuse discharge. Although 
this assemblage of symptoms may excite strong suspicions of encysted 
placenta, we cannot determine with certainty, the real condition of the 
case, until we have introduced the hand in utero ; and where there is 
much hemorrhage with these manifestations, the hand should always be 
introduced, and the difficulty ascertained. If stricture be found to exist, 
it should be carefully dilated, and the placenta be removed, according to 
directions inculcated by all obstetrical writers. 

The inquiry here naturally suggests itself — How long shall we wait 
before resorting to manual interference ? Burns says, that we should in 
no case delay the removal of the placenta longer than two hours, and 
Ramsbotham, longer than an hour and a half. Now all such limitations 
are arbitrary, and sometimes very injudicious. The reasons for manual 
interference may be as valid after the lapse of half an hour, as at a later 
period. In my own practice I never exceed one hour. If the placenta 
be not expelled in one hour, it is absolutely uncertain when it will be 
expelled, or whether it will be expelled at all by unaided effort. The 
introduction of the hand for the delivery of the afterbirth, is more readi- 
ly effected, gives less pain, and consequently is safer, within the first 
hour after the delivery of the child, than after a later period. It is a 
principle upon which I have always acted, never to leave my patient's 
bed-side until she be delivered of the placenta. I have been called upon 
in many instances, in the practice of midwives, and often in that of regu- 
lar practitioners, to deliver the placenta after the lapse of twelve or four- 
teen hours, but the operation is much more painful to the patient, and 
difficult to the operator. I have never in a single instance put the patient 



1854.] Johnson — Retention of Placenta. 83 

to bed, with a retained placenta. I have known several instances where 
it has been done, but they all but one proved fatal. That one was the 
wife of a medical man, and the placenta came away within twenty-four 
hours. A patient of this same practitioner did not fare so well ; the pla- 
centa was left, and death ensued in a few days. In another instance, in 
the practice of another accoucheur, the patient was put to bed, with the 
placenta unremoved, and the reason assigned by the doctor for such con- 
duct was, that she had already flooded so much, that he was fearful she 
would die in his hands, if he attempted its removal ! She did not die 
from hemorrhage, but she died shortly after from irritative fever. I 
have called up these reminiscences of by-gone days, only to point out the 
rock on which others have split. The practitioners have both deceased, 
and no one's feelings can be wounded by this recital. 

In almost every instance of retained placenta, from irregular uterine 
contraction, the introduction of the hand is the only means worthy of de- 
pendence. Opium and ergot have both been proposed as remedial agents; 
in neither of them have I the least confidence. In fact, I have seen posi- 
tive ill effects from the ergot. I have administered it a number of times 
for the expulsion of the placenta, but have always been disappointed 
with its action. 

We have now decided upon the necessity of the introduction of the 
hand into the womb, for the removal of the placenta 5 the next point to 
settle, is the position of the patient. Ramsbotham advises, that she re- 
main in the position in which she has been delivered, namely on the left 
side, and that the left hand of the operator be used in removing the pla- 
centa. I respectfully dissent from this precept. The position in which 
I invariably place my patient, for all obstetrical operations, is that advi- 
sed by Baudeloque, in instrumental labor, viz : on the back, with her 
breech resting on the railing of the bed, her legs separated, flexed, and 
resting in the laps of assistants sitting before her. In the case under 
consideration, as instruments are not to be employed, I have the patient's 
head and shoulders, and trunk, raised to an angle of forty-five degrees, 
by a chair turned over on its forepart and covered with pillows, and 
placed under her. This is the position in which I deliver ninety per 
cent of all my obstetrical patients. In making this declaration, I am 
aware that I may incur the animadversion of my professional brethren. 
Be it so. I could offer many arguments in its favor, but this is not the 
place for its discussion. But certainly in the present instance, this posi- 
tion is to be preferred to all others. The right hand can be used by the 
operator for entering the womb, whilst the left hand fixes the uterus in 



84 Original Communications. [March, 

situ. In fact, all manipulation on the uterus through the abdominal pa- 
rietes, are more conveniently performed, when the patients are placed in 
this position, than in any other. 

The operator having taken off his coat, rolled up his shirt sleeves, and 
anointed his hand and forearm with some unctuous substance, as hog's 
lard, sweet oil, &c, places himself with his chair between the patient's 
legs, and introduces his hand in a state of supination, with the thumb 
placed close in the palm, and his fingers forming a cone, with a gentle semi- 
rotary motion, until he has entered the vagina ; he then passes his hand 
into the uterus, until he comes in contact with the stricture ; the cone 
formed by his fingers, is to be pushed steadily against the opening until 
it yields', and the hand penetrates" it. The whole hand is then to be 
passed over every point of contact between the placenta and Uterus. If 
adhesions be formed, they are to be destroyed ; if a cornu be found, it is 
to be entered, dilated, and the placenta disenthralled. The whole mass 
is now to be gathered as it were into the palm of the hand, and with- 
drawn from the uterus ; it sometimes however happens, that at this stage 
of the operation, the uterus is stimulated to such energetic action, as to 
expel both the hand and placenta. But sometimes a very unexpected 
difficulty is to be encountered. It has happened to others, and was once 
a source of very great embarrassment to myself, that where the stricture 
has been an hour-glass contraction, that in attempting to withdraw the 
placenta from the upper chamber, the stricture has returned and firmly 
embraced the wrist, completely preventing the withdrawal of the hand 
with the placenta. Now, if the operator let go his hold on the placenta, 
and withdraw his hand, for the purpose of dilating the stricture again, 
the same difficulty will again be produced, in another attempt to extract 
it. But by placing the thumb firmly in the palm of the hand, and with 
it grasping a portion of the placenta, the whole may easily be removed, 
and the stricture effectually dilated by the wedge which this manoeuvre 
brings to act on it. I do not recollect seeing this manipulation noticed 
by any obstetrical writer except Dewees, but I remember encountering 
such a case, and the source of embarrassment it was to me, years before 
I saw Dr. Dewees's work. I had penetrated the stricture, detached the 
placenta, and was removing it, when I found that the stricture had re- 
turned and was firmly embracing my wrist. After some reflection, with 
my hand still in the upper chamber of the hour-glass, I came to -the 
adoption of the method just stated, and removed the placenta. This may 
seem a small affair; but to one who may have had to encounter this dif- 
ficulty, I think that there is no danger of its ever being forgotten. In 



1854.] Johnson — Retention of Placenta. 85 

every instance where the placenta has been removed by the hand, from 
the uterus, let it be carefully examined whether any part have been dis- 
rupted, and if such have been the case, the hand must again be intro- 
duced, and the disrupted portion be removed. 

In all these operations, I would advert to one principle as paramount, 
viz : always to support the fundus uteri loith your own hand placed on 
the abdomen of the mother, and never to trust this part of the operation 
to the hand of an assistant, whilst the other hand is made to penetrate 
into the uterine cavity. Disruption of the connection between the vagina 
and uterus, might result from the neglect of this caution, This direction 
is easily observed, if the patient be lying on her back. In all these cases 
as well as in those of the most natural deliverance, ascertain afterwards 
the degree of contraction of the uterus, by the hand placed on the abdo- 
men, but in almost all these cases of artificial deliverance, the womb will 
be found to be firmly contracted. 

I have been more diffuse than I had proposed at the commencement 
of this essay, and perhaps what I have written is but the echo of obste- 
trical writers. I have not yet adverted to the principal object I had in 
view at the commencement, viz : — to investigate the probable causes of 
these abnormal affections. 

On these points there is much discrepancy of opinion, I would there- 
fore approach the subject with diffidence, but truth suffers nothing by 
agitation. The most elaborate speculations however, on mooted points, 
dwindle into insignificance unless established on facts. The dogmas of 
the learned are often received with too much credence, and their teach- 
ings acted upon without questioning their validity; position invests error 
with authority. It is not my wish, however, to be censorious, or to de- 
tract from the claims of well earned merit, but simply to arrive at truth. 
The opinions which I am about to contend for, I know are at variance 
with those of the most eminent obstetricians, particularly with those 
of Burns and Ramsbotham; names which are as household words in the 
republic of medicine. 

When I first entered on the practice of midwifery, I took the eldet 
Baudeloque as my guide. I looked upon his systen of midwifery as the 
most perfect we then possessed. No obstetrical writer previous to him 
had manifested such a thorough acquaintance with his subject, and none 
had brought so much erudition to bear upon it. My whole obstetrical 
course was for years influenced by the teachings of that truly great man. 
Among the precepts which he inculcated, was that of danger of atony of 
the uterus from the too sudden emptying of that organ ; thus leaving 



86 Original Communications. [March, 

patulous the uterine sinuses, and subjecting the patient to frightful he- 
morrhage. In his chapter on the action of the uterus, he depicts in the 
strongest colors the danger of atony of that organ ; and it was an ap- 
prehension of that danger, that deterred me from pursuing one of his di- 
rections with respect to the delivery of the child ; a direction which I now 
consider orthodox and based upon sound obstetrical principles. It was 
this — to assist the expulsive efforts of the uterus, by traction on the 
child as soon as the shoulders have arrived at the vulva. I was preju- 
diced against this interference as I observed before by Baudeloque's own 
writings, and this prejudice was strengthened by the general precepts of 
Denman, Bard and Burns ; particularly by the latter, To his (Burns') 
monograph on Uterine Hemorrhage, he has appended a chapter on the 
management of the placenta. In that chapter he insists upon the impor- 
tance of preventing the sudden expulsion of the child from the uterus j 
and where that event is threatened he directs prevention of it by pressure 
on the child. He advises this course, not so much with a view of pre- 
venting hemorrhage, as that of preventing irregular contraction of the 
uterus. His reasons seemed valid, and his precept worthy of confidence, 
and for years I implicitly followed it. It struck me too, that by retard- 
ing the birth of the child, when it threatened to be rapid, by a hand 
placed on its head or shoulder, it would compel the uterus, to throw it 
off so gradually, as to bring about perfect contraction of the organ, and 
thus close its patulous vessels — hemorrhage and irregular contraction 
being both thus prevented. 

A more enlarged experience convinced me that both Baudeloque and 
JSurns were in error. The former had exaggerated the danger of atony 
of the uterus by the rapid expulsion of the child. I found that where 
the action of the womb was sufficiently energetic, to throw out the child, 
as it were at a pain, it did not often cease with that effort, but continued 
to contract upon the placenta. I was also convinced that Burns' precept 
was unsound, as will appear in the sequel. 

In the early periods of my practice whilst I compelled the uterus, as 
it were, to expel the child gradually and by its own unaided efforts, even 
retarding its expulsion when it threatened to be rapid, I had very fre- 
quently to encounter irregular contraction on the placenta, rendering ma- 
nual interference necessary for its removal. The most frequent form of 
irregular contraction which I met with, was that noticed at the com- 
mencement of this essay. This form of irregular contraction, I believe 
was very frequently produced by suffering the too gradual expulsion of 
the child from the uterus ; especially by suffering the feet and legs to be 



1854.] JoiiNSON — Retention of Placenta. 87 

expelled by uterine effort. The longitudinal fibres of the uterus by this 
means were kept quiescent, and the circular fibres alone permitted to act. 
Here was the first link in the chain of perverted action; and how soon 
perverted action becomes persistent, every observant man must have wit- 
nessed. The perverted action which was excited by the detention of the 
child's feet and legs in utero, is continued upon the placenta, and instead 
of that body being expelled, it is firmly detained. Thus the precept of 
Burns, viz : — To compel the gradual expulsion of the legs and feet of the 
child, in order to prevent irregular uterine contraction, leads to the very 
production of the accident. On this point careful observation has made 
me confident. 

I do not pretend to originality in the views which I have taken of the 
causes of retained placenta, from irregular uterine contraction. About 
twenty-five years since, I read with much interest and profit, a very elabo- 
rate and most judicious essay upon the " safe delivery of the placenta," by 
Samuel Jackson, M. D., of Northumberland^ and now of Philadelphia, 
published in the " American Journal of the Medical Sciences." From 
a few hints in that excellent essay, I was led to much thinking on this 
subject, and from thinking to acting. My views of the causes of irregu- 
lar uterine contraction, are now the very opposite of those which I formerly 
entertained, and my practice founded on such views, is also very differ- 
ent. Instead of retarding in any degree the expulsion of the child, when 
it threatens to be effected too rapidly, I suffer it to pass without any ap- 
prehension of uterine inertia from this cause. I not only do this, but I 
now never suffer the legs of the child to be expelled alone by uterine 
effort, but always remove them as soon as the hips have passed the vulva, 
by traction on the child. But I always endeavor to accomplish this be- 
fore the uterine effort has expended itself If the pain which has expelled 
the shoulders of the child, has not expended more than half its force, I 
I make it complete the delivery by traction on the child. In fine my 
practice now is, that the feet and legs of the child never be expelled by 
unaided effort, and never if possible with an expiring pain. 

As the result of this practice I must state, that whereas irregular ute- 
rine contraction, was a frequent occurrence, whilst following the direc- 
tions of Burns, it is now comparatively a rare one. I think that I may 
safely say, that where I now encounter one case of irregular contraction, 
I formerly had six or eight, and perhaps I might make the ratio much 
higher. I have kept no statistics, but think that I can safely trust to 
my reminiscences of practice. I have given the result of more than forty 
years experience. For eighteen years I followed the directions of Burns, 



8£ Original Communications. [March, 

viz : making the uterus expel the legs and feet of the child, in order to 
prevent irregular uterine contraction. For the last twenty-four or twenty- 
five years, I have pursued a directly opposite practice, and I have given 
the results. The subject is an important one, and if my remarks direct 
attention to it my labour has not been thrown away. 

I think that I have demonstrated one of the most frequent of the 
causes of irregular contraction. I do not say that it is the sole cause. 
The high authority of Ramsbotham makes the sudden emptying of the 
uterus a cause of irregular contraction. If it be so at all, it will in all 
probability be that of the globular form of contraction. I cannot myself 
conceive of any other form from this cause. I have witnessed this form of 
irregular contraction, where the womb has been suddenly emptied, but 
was not satisfied of the validity of this cause. For how seldom do we 
witness the supervention of this accident from the sudden emptying of 
the womb ! 

Among the causes of this affection, I think that I may set down, from 
personal observation, that of the ergot. When the uterus has been too 
early urged by this drug to energetic action, and the child be not expelled 
until the organ become fatigued, its actions are then irregular, and if the 
child be expelled when the uterine effort be expiring, such a result may 
happen. I think that I have frequently witnessed this. 

Does not the presence of the hand in utero sometimes produce irregular 
contraction ? I will answer the question by the brief relation of a case. 
Some years since, I had a case of retained placenta, with much he- 
morrhage. There was remarkable inertia of the uterus. The hand 
passed up to the fundus without exciting the slightest contraction. By 
and by I felt the womb contracting before my fingers into a cornu on the 
left side; I entered it and liberated the portion of placenta, and con- 
tinued to pass my hand between the placenta and uterus on the right 
side, and the same impression was again given to the fingers ; another 
cornu was formed, and it was also entered and the placenta liberated. 
The uterus was now aroused to general action, and the placenta and hancl 
expelled. The impression was produced in my mind, whilst the hand was 
in utero, that this irregular contraction was produced by my fingers. If 
this were not the case and cornua previously existed ; contraction was 
certainly produced whilst my fingers were in contact with those parts. 
The contraction was sensibly felt here, whilst the body of the organ was 
torpid. It is a solitary case.- I have never been sensible of such irregu- 
lar contraction since, although I have so repeatedly passed my hand, 
both into the empty and loaded uterus. 



1854.] BROWN — Gangrenous Erysipelas. 89 

To sum up what I have advanced on this subject — 

1st. Far the most frequent of all the causes of irregular uterine con- 
traction, is that of the gradual and unaided expulsion of the legs and 
feet of the child. 

2d. The too early exhibition of the ergot in labour. 

3d. The too sudden emptying of the uterus. Deference to the highest 
obstetrical authority compels me to admit this among the causes of irre- 
gular contraction; at the same time I must candidly confess, that 
although I have witnessed irregular contraction where the uterus has 
been suddenly emptied^ I looked upon it more as a mere coincidence than 
as a cause. 

4th. The presence of the hand in utero under a state of unusual inertia 
of that organ. 

White House, February, 1854. 

Gangrenous Erysipelas. By W. Mortimer Brown, M. D. 

There are few forms of disease in which the benefit of remedial mea- 
sures is more conspicuous, than in erysipelatous inflammation ; yet occa- 
sionally we meet with cases in which the disease marches forward to a 
fatal termination, as little checked or changed by all the means that art 
and science can bring to bear upon it, as cyanosis or fungus hsematodes. 

Acute Erysipelas, characterized by sharp stinging heat, and shining 
redness of the skin, disappearing on pressure, but immediately return- 
ing, with much febrile excitement of the general system, preceded often 
by one or more chills, is the form most usually met with, and is often 
connected with, if not dependent on a diseased state of the liver, stomach, 
or some other of the internal organs, the detection and removal of which, 
forms the first and often the only step in the treatment; the secondary 
subsiding as the primary disappears, Where this is not the case, blood- 
letting and the free use of cathartics, with a general antiphlogistic regi- 
men and the local application of blisters, nitrate of silver or mercurial 
ointment, have with me proved almost invariably successful. 

This last, though by many writers considered useless or injurious, has 
in my experience been of great value, and where it has been used in the 
same case with other applications, the more rapid improvement under its 
use has generally been visible in a very short time. In cases where 
both sides of the face, or both arms were affected, I have directed the 
ointment to be used on one side, and other applications on the other, and 
bo sensible has been the difference, that in many instances the patient 



90 Original Communications, [March, 

would insist on using no application but the ointment. I was led to 
make the trial from a suggestion of Dr. Dewees, and have seldom been 
disappointed in looking for a favorable result, though I have not found 
it necessary to push its use to such an extent as to induce salivation in 
any instance. 

When the disease is seated in the throat, and is attended with oedema 
of the glottis it is very intractable. Though the attack may seem mild, 
and the sympathy of the general system slight at first, labored respira- 
tion soon comes on, the fever settles into the typhoid type, and all efforts 
to arrest the onward progress of the disease seem vain, though tonics, 
general and local, have been used with an unsparing hand, as soon as the 
change of type seemed to call for their use. Whether a tonic treatment 
from the commencement would be more successful I am unable to say, 
depletives local and general having usually been employed for a few days 
during the stage of excitement. 

Observation in the wards of a public hospital, early brought to my no- 
tice that form of sloughing erysipelas, known as hospital gangrene, 
spreading with rapid strides from bed to bed, and sweeping away at a 
stroke, the fondest hopes of the Surgeon in the success of an operation, 
and bringing to a fatal termination incisions the most trifling, or leaving 
tedious sores or unsightly stumps where early union and serviceable ex- 
tremities were confidently looked for; but in private practice this is rarely 
met with, and seldom exhibits the same degree of virulence. The follow- 
ing case seems, however, sufficiently obstinate, and was marked with 
some unusual features worthy of a passing notice. 

M. S. Age about 40, — full, robust habit. June 1st, found the fore- 
head and right eyelids affected with erysipelatous inflammation — the up- 
per eyelid much swollen and very hard, the conjunctiva much congested, 
and a spot in the centre of the forehead, nearly an inch in diameter, 
black and hard like leather. The globe of the eye seemed unaffected, 
and vision was perfect when the lids were separated, so as to permit the 
light to reach the eye. Pain greatest in the forehead ; little sensibility 
to pressure ; pulse 100, full ; slight white coat on tongue ; bowels costive; 
good appetite ; thirsty ; had been sick about a week ; had been leeched a 
few days ago without relief — ordered magnesia and salts taken until the 
bowels should be freely moved ; a solution of cream of tartar to be used 
as a drink; sulph. zinc dissolved in rose water, to be applied to the eye, 
and at night a cold poultice of ground slippery elm. On the 6th, no im- 
provement taking place, but the inflammation extending, mercurial oint- 
ment was ordered to the inflamed surface, and the conjunctiva was freely 



1854.] Brown — Gangrenous Erysipelas. 91 

scarified. On the 8th the cold poultice at night was omitted, solution of 
nitrate of silver applied in place of mercurial ointment, and 5 grs. of 
blue pill given every night until the 13th, when symptoms of ptyalism 
appearing, it was omitted. 16th. A black spot appeared over the eye- 
brow. 18th. Ulceration commenced on the upper eyelid. Sleepless. 
Ordered 5grs. nitrate of potash and 3grs. Dover's powder every four 
hours. 27th. Ulceration spreading — vision lost in right eye ; pulse 110j 
feeble ; appetite failing— ordered 9grs. sulph. quinine during the day. 
30th. Worse. Ordered sulphate of iron gr. ii, three times a day, chlo- 
rate of potash gr.vj, every two hours, and wash ulcer with solution of 
sulphate of iron. Continue nitrate of silver. 

July 1st. The solution of sulph. of iron was increased to xii grs. to 
the ounce, and 20 drops of muriated tinct. of iron given every two hours. 
2d. A poultice of ground flaxseed, with prepared charcoal, was applied 
to the ulcer, and the next day cod-liver oil substituted, but both seemed 
to increase the irritation, and were omitted. The oil, however, was con- 
tinued internally. From the 6th to the 13th, quinine and carbonate of 
ammonia were given in large doses without restraining the onward pro- 
gress of the disease. 13th. Abundant discharge of foetid purulent mat- 
ter — upper eyelid nearly gone — no appetite — trembling — delirious — 
pulse 100, weak. White slimy coat on tongue, with dark streaks — diar- 
rhoea. Solution of iodine was ordered to be applied alternately with 
muriated tincture of iron. Iron was also taken internally in full doses. 

At this point there seemed a change for the better. A solution of 
chloride of lime was used to correct the fcetor, Dover's powder was given 
occasionally to procure a little sleep, catechu to restrain the diarrhoea, 
and elixir of vitriol, quinine and beef tea, to build up the system, and 
apparently with effect, as all the symptoms improved, the black slougha 
separated, healthy granulations sprung up, the pain gradually subsided, 
the pulse became stronger, the bowels regular, the appetite good, and on 
the 23d the prospect seemed favorable for recovery, when suddenly the 
strength began to fail, all the unfavorable symptoms returned, constant 
delirium, then coma ensued, and death closed the scene in about a week. 

Several of my professional brethren saw the case with me, and have 
given me the benefit of their suggestions, and from the failure of the 
means first made use of, we felt inclined to give a thorough trial to the 
preparation of iron, so highly recommended by John and Sir Charles 
Bell, in erysipelas, but, as we have seen, in vain. 

From the failure of the tonics in this case to arrest the disease, and 
from its resemblance to noli me tangere, I should be inclined to make a 



92 Original Communications. [March, 

trial of arsenic if a similar one should present itself. But the case is of 
rare occurrence in private practice, and is not a common one even in hos- 
pitals. 

I have seen cases where the skin looked as black as if a heavy blow 
had been inflicted, but in other respects there was little resemblance to, 
the above case, and the treatment pointed out in the first part of this 
article has usually given speedy relief. 

Newark, N. J. February, 1854. 

"The Change OF Life," in Women; with remarks on the periods 

usually called " Critical" 

By Joseph Parrish, M. D. 

NUMBER III. 

Power of Female System— Evidence of it, in Sympathy, Conception, Growth of 
Embryo, Cessation of Menses, Lactation,— Power hidden, — Moral and Mental 
Changes. 

In the changes to which reference has been made, there is an allusion 
to the power, or capacity of the female system. The power exercised by 
the generative organs, upon other parts of the body, and the reciprocal 
influence or control, felt by these organs, from other parts. Leaving for 
the present, the question of diseased action, we may consider these con^ 
gregate systems, in their normal dependencies on each other. 

Power is a significant word. It implies the exercise of some inherent 
force. If that force is latent, its exhibition proves the power of develop-, 
ment. It is active — it is the vis a iergo through which the life force 
speaks in the progressive existence of the being. Without it, there can be 
no growth. The wheels of life cannot move in their circle of organic 
structures. The machinery by which the productions of the animal are 
evolved, must of necessity be arrested; and certainly, as the wise man has 
said, will " the pitcher be broken at the fountain." Death is the result 
of a want of power, whether it be from disease, or the natural wearing 
out of the thread of life. This suggests the idea of the limited nature of 
this motive power : limited, because the life of the animal is itself con- 
fined within certain bounds ; and if it be limited, it may be modified. It 
may be excessive in its manifestations at one particular part of the body ; 
or other, and distant influences may take from it, a portion of the energy 
allotted to that part, by which it must necessarily suffer. 

Now in the change of girlhood, called menstruation, there is not only 
strong evidence of this power, but of its action through sympathy. 



1854.] Parrish — Change of Life in Women. 93 

The uterine system, being the great central characteristic of female 
life, around which moves the circle of all the mental, moral, and 
physical phenomena, peculiar to this stage of existence, the flow may 
be affected through either of these media, both as to the time of its ap- 
pearance, and its character. For example — if the mind should be over- 
taxed, and the vital force summoned to the support of the mental effort, 
to a degree beyond its share, the uterine supply may be measurably 
withheld, and the production which should result from a fair and equa- 
ble working of the machinery, may not be evolved. The law of sympa- 
thy, in full force, in such a case, between the mind, which maintains its 
supremacy, and the struggling uterus, the latter is robbed of its propor- 
tion of vital energy, and the whole system, thus disturbed in its sympa- 
thies, and relations, gives evidence of disorder in some form. Again, a 
fright, or any strong emotion, may react upon the uterine organs, and 
produce an excessive flow of the menses. And yet again — a physical 
injury, or shock, as a sudden fall, or fatiguing exercise, may, by a reflex 
movement, contribute to the hasty, if not premature developement of tjie 
uterine flow, by the operation of the same immutable principle. 

The uterus, that has been dormant for years, and is now aroused, produce 
ing a new fluid, by which its capacity may be known and measured, possesses 
the power of conception. In this function likewise, it demands the sympa-* 
thies of the entire being, of which it forms a part. The mental, moral, and 
physical attributes of that being are exercised in all its performances. 
The impressions that fasten themselves upon the mind, the moral emo- 
tions which spring up simultaneously in the heart, and the physical 
changes that occur, all bear an interesting, and important relation to 
each other, and each contributes its portion, to maintain the uterus in 
its oflice. The new organ and its appendages, are all alike concerned. 
The uterus itself — its tubes- — its ovaries — its vagina — each has a share in 
the change. The absence or inability of either, will impair, or de- 
stroy, the perfection, and harmony of the arrangement, and the uses it 
is intended to serve. There is likewise power to mature a living being. 
The generative apparatus developed now, and in the fulfillment of a nat- 
ural law, is still undergoing change. Menstruation and conception have 
already occurred. The speck that forms the embryo, must grow out of its 
embryonic state, and assume its foetal life. The foetus in utero must 
develope its proportions in due season, and then become a living being 
in the world of life without. The changes in size, shape, &c, of the em- 
bryo, and foetus, are marked by corresponding changes in the habits, 
feelings, and tastes of the mother, all of which are striking, but too fre- 



94 Original Communications. [March, 

quently unregarded, if not unobserved. Mark tnem= — The uterus 
from a passive organ, some two inches in length, gradually enlarges, 
rises out of the pelvis, extends upwards towards the chest, and widens 
laterally, till it occupies nearly the entire abdomen. In texture it is also 
altered. From an apparently solid mass of muscle, divided by a single 
fissure, it is stretched into a thin texture, till distinct fibres are seen ex- 
tending in various directions, and the internal cavity, instead of being a 
thread-like cleft in the substance of the organ, becomes the residence of 
a living being, of human form, and dimensions. The Fallopian tubes are 
pressed aside ; the ovaries crowded out of their place ; the vagina laden 
with a heavy weight, and often enormously congested, the bladder flat- 
tened, and the intestines greatly compressed. For six months at least, 
this state of things is experienced in a greater or less degree, until the 
time of parturition comes, when, by the sudden removal of the contents 
of the womb, it collapses into its former state ; not however by a gradual 
decline, but by the most heroic throes of nature, in the exhibition of 
tremendous power. And with its return, its appendages follow, and take 
their wonted places, the viscera are replaced, and the whole organism 
again restored. 

Let us not overlook the fact, that with the occurrence of conception, 
the menses cease to flow, and that with the close of pregnancy, lactation 
commences. Cessation of the menses at the occurrence of gestation, is a 
natural and legitimate consequence. It may be true, that there are ex- 
ceptions to this rule, but the rule is still the same. And it is an ob- 
viously wise one. The womb, when menstruating, performs a function 
widely different from what it is called to, in the process of gestation, and it 
may not exert two opposing forces at the same time. Lactation has likewise 
its separate design, — a design affecting not merely the child, that is to be 
nourished at the maternal fountain, but one adapted to protect the 
constitution of the mother. The breasts, in furnishing a supply 
of nutriment, allow the womb, to which they are allied by a near sym- 
pathetic relation, to rest, perhaps for a whole year, during which time 
the female is saved the toils, and trials of the pregnant condition. All 
this is natural. The vast changes that have been described, as occuring 
during the long period of utero-gestation, from the time of its commence- 
ment to its close, are all in obedience to the law of life — all natural ; 
and the physician does not interfere to arrest, or scarcely to modify 
them. Take for example the " morning sickness,' 7 that passes like a 
a wave through the whole economy, disturbing the repose of almost every 
organ, and for three consecutive months, subjects its victim to harrassing 



1854.] ParrIsh— Change of Life in Women. 95 

■discomforts, that no medicine can relieve. The vomiting, and general 
distress, dependent upon this condition of the system, is not disease, un- 
less pregnancy is disease. It is a symptom of gestation, and if there be no 
departure from health in the cause, the symptom cannot be morbid. 
The experience of the profession everywhere, and in all times, corrobo- 
rates this view of the subject. As far back as the days of Hippocrates, 
the illustrious Father of medicine declared*-— " If the catamenia are 
suppressed, without being followed by rigor or fever, hut hy disinclina- 
tion for food, pregnancy may be suspected." Who then would treat 
the vomiting of pregnancy as gastritis ? Or who would subject his patient, 
under such circumstances, to a " course of mercury," for example, as 
he might be disposed to do, if pregnancy did not exist ? As a gene- 
ral rule, no treatment is required in the pregnant condition, if the pa- 
tient will but observe ordinary hygienic rules,- So when the period is 
at an end, and the child is born, but little medication, if any, is 
necessary, unless disease may interfere, and demand professional aid. 

In all these changes, striking and wonderful as they are, nature is the 
kind Physician, who counsels, and whose gentle hand directs the power, 
that accomplishes them all. We cannot estimate their extent, because 
they are performed in silence and obscurity. As the hidden seed in the 
bosom of the soil, that shoots forth, and grows, and becomes the wide- 
spread shelter, and the prolific bearer of goodly fruit, performs all its 
wonderful changes in unobserved stillness, moved by a concealed vitality, 
that no art can supply — so do the " changes in the life of women," that 
are connected with the uterine system, go on in the mysterious chambers 
of her own organism. The hidden uterus, aroused from its long lethar- 
gy, grows, and developes the whole being, first, *;giving evidence of its 
power to execute the command to "Be fruitful and multiply," and then 
by the same inherent vis vitale, spreading out, and affording shelter for a 
living being, and bearing it into the world. 

With all these physical changes and developments, we should not 
overlook the differences in moral and mental character. The change in 
these respects occurring at mature girlhood, have already been noticed ; 
but as those presented during the course of utero gestation, too often 
escape observation, perhaps some of them may be recalled here. The 
morbid temperament, often irritable, and exceedingly sensitive, and it 
may be desponding; and the seemingly disordered, and even loathsome 
appetite, in the early months of the pregnant female, must be familiar 

* Aphorisms of Hippoc. sec, v. ^f. \xl 



96 Original Communications. [Marcs, 

to the careful observer. With the "disinclination for food," or the 
unnatural appetite) and the distressing sickness, it would seem reaso- 
nable to anticipate a sensitive temper, a dispositisn for retirement, even 
from the fondest friends, and a morbid feasting of the mind on imagina- 
ry ills, and delusive fears. But when we can realize these exhibitions of 
character, as the result of uterine disturbance acting sympathetically 
upon the brain, we shall reach a physiological fact, that may serve us an 
important purpose, in other manifestations of change that may occur in 
the uterine function. It is not urged that these peculiar displays of phy- 
sical phenomena are universal, but that they, or some kindred exhibitions 
of perverted taste both mental and physical, are exceedingly common, no 
one will attempt to deny. Take a lady for example, of refined and amia- 
ble disposition, who during the first few months of pregnancy, shows a 
character just the reverse of her accustomed habit; and it cannot be 
satisfactorily accounted for, in any other way, She is dissatisfied with 
herself, mortified, and grieved, and yet she cannot control her feelings 
and desires. They are indications of a state of the system, at once pecu- 
liar, and astonishing ; indications that point to a series of connecting in- 
fluences between the thinking, and the generative powers, that shows 
them to be intimately associated. 

Now if they be so closely related, and the uterus may produce such 
marked changes in the mental character, why not the brain react upon 
the womb, and create a corresponding diversity of effects ? For the time 
comes in the history of female life, when the mind acts with mature 
vigor, and the generative organs decline. 

Let us explain. The changes in the uterus connected with conception 
and its immediate results, are independent of mind. They occur when 
exposed to the natural stimulus, whether the will of the individual con- 
curs, or not. The mind may oppose, and yet the cell that is lodged in 
the womb, shall grow out of its own life, into its embryo state, and then 
onward to its foetal existence. But not so in the dreaded " change 
of life," occurring in more advanced years. When the uterus will have 
lived out its term of active service, return to its first estate, and be- 
come again a passive organ; the mind will have just grown up to its 
full proportions, and be capable of acting with a corresponding power. 
It is therefore suggested, that if the individual be taught to anticipate 
this change, with cheerful expectations, many of the ills now attendant 
upon it, may be avoided. 
Let us enquire what they are. 

TO BE CONTINUEDc 



1854.] Correspondence. 97 

CORRESPONDENCE. 



Physicians' League. 

February, 9, 1854. 

S. W. Butler, M. D. — The perusal of your address, read before the 
District Medical Society of Burlington County, reminded me of a cher- 
ished idea tending to the pecuniary advancement of the profession. 
Your plan of bringing the members of the profession often together in 
harmonious evening meetings, to compare notes, encourage, advise, and 
counsel each with the other for the benefit of the whole and the public — 
would have the happiest effect to elevate the profession in the estimation 
of the more intelligent portion of the community. They would feel that 
here was a consultation for the common good, and not at their expense. 
Hence would we receive and enjoy some return in cherished good feeling 
for the vast amount of labor that we must of necessity do for nothing. 
Then, instead of each practitioner watching his brother with an envious 
or a jealous eye, — lest by some chance he may be called to visit his pa- 
tient — each would freely present any and every case of interest that 
might occur in practice, would freely declare his treatment, and ask the 
suggestion of any change, or addition that might promise any meliora- 
tion of persistent bad symptoms in a given case. If perchance one of 
the circle has met a case which yielded to some new composition, or new 
medicine as to a charm, he would, for the benefit of the whole and the 
public weal, detail minutely all the symptoms, promulge the composition, 
and encourage all the rest in any such case, to give the medicine a trial 
and report the results. Herein is the benefit of such frequent re-unions. 

" Re-unions" did I say ? Yes, indeed such a spectacle in our county 
would in truth be a re-union. For, in the minds of most of the practitioners 
in this county there seems to have grown — and the stronger as age lays 
its silvery fibres among the raven locks — an idea that because employed 
for a time, to them are sold bodies (and souls almost) of every such fa- 
mily. Consequently, any new comer is looked upon as in intruder upon 
vested rights. And if the unoffending man who answers to the best of 
his ability the call of one of these fee simple patients, is foolish enough 
to join in the quarrel, a three cornered fight most readily ensues. To all 
such practitioners, morbidly sensitive as they are, I would propose the 
formation of district medical societies, or social medical circles — in fact a 
re-union after the plan suggested in your valuable address, If not this, 
jet them avail themselves of the facilities now offered at the Patent 
Department and have the rights and interests they have acquired in their 



98 Original Communications. [March, 

patients patented, and then the strong arm of the law will control the 
public opinion. 

The obligation of patient to physician is measurably cancelled when the 
bill is paid. The recent action of your society directing the presentation 
of bills at the expiration of the periods of sickness, is good, and would 
lead very much to favor the harmonious gathering so much desired. For 
the older physicians who can live without calling frequently for settle- 
ments, often use the pecuniary obligation of families as a lever power to re- 
tain their business. It is the more effectual in communities where money is 
less plenty, and the old system of trade and barter has not been outlawed 
by the cash system. 

But still another bond of union may be formed in what I have 
used at the head of this communication, and named the Physician's 
League. The experience of every younger practitioner of medicine 
has taught him, that the readiest to employ him are those who 
never pay any physician. They patronize each in turn, till each 
wants pay, then a new one is sought out. Such patronage every 
young doctor has, until he is almost patronized to starvation. The 
League I would propose — pre-supposing the re-union already advocated 
— is, that each practitioner should collect as promptly as possible, and 
report to his circle all such as refuse to pay, and those who are able and yet 
unwilling to pay, should be marked by all the rest, and their patronage 
respectfully declined till the indebtedness is cancelled — this would result in 
good to all. Such a plan was once adopted by a district society in your 
State, but owing to some jealousies not counteracted by a frequent meet- 
ing together, it failed of its object. Let me further say, that this propo- 
sition does not intend to include such as from protracted illness, misfor- 
tune, or extreme poverty are unable to pay. Such every honorable phy- 
sician feels it a pleasure to attend, and do all in his power to relieve their 
misfortunes gratuitously. M. D. Jr. 

Professional Standing; its decadente; the'canse; how to be remedied; radical- 
ism ; " Young America ;" evil's of present College system ; American Medical 
Association; controlling influence of the Schools; hence the Association has 
been thus far a failure ; the remedy. 

Washington, D. C, February 17th, 1854. 

Mr. Editor — I owe you an apology for not having acknowledged at 

an earlier date, the receipt of your able and interesting address delivered 

before the District Medical Society for the county of Burlington. Apart 

from the deep interest I feel in the subject discussed by you upon that 



1854,] Correspondence. 99 

occasion, that courtesy, respect and sympathy, due to a co-laborer in so 
good a cause, would have prompted an immediate response from me, had 
not the pressing engagements of an active professional life intervened to 
prevent, up to the present moment. I have read your address with much 
interest and attention, and am gratified to find you assume upon many 
important points connected with the general welfare of our profession, 
the same positions occupied by myself. After adverting to the humilia- 
ting fact that there has been a retrograde in the standing of the medical 
profession since the days of Sydenham, Fothergill, and others of that 
time, you go on to demonstrate the causes which have conspired to pro- 
duce this decadence of professional respectability and influence in socie- 
ty, by discussing them under three different heads. 1st. Defective me- 
dical acquirements, including their antecedent causes. 2d. The advance- 
ment of quackery and its connexion with the regular profession, &c. &c. 
3d. Want of union and harmony among scientific physicians. Without 
wishing to offer any comments upon the two latter of these divisions, 
upon which you have dilated somewhat in extenso yourself, you will ex- 
cuse, I hope, the indulgence of a propensity I feel just at this moment, 
to submit a few observations upon the subject involved in the first. There 
can be no doubt as you justly remark, that whilst the science of medi- 
cine, through the assiduity, labor, and researches of a few scientific and 
distinguished members of the profession, has been gradually progressing, 
and is now far in advance of what it was a century ago — the standing, 
respectability and influence of its members as a body, are far below what 
they were at that date, or even at a much later period. I refer specially to 
the personnel of the profession in our own country ; its present position in 
society, and its professional and literary attainment. No one, I presume, 
who will take the trouble to institute a comparison, can arrive at a dif- 
ferent conclusion, or hesitate to make this mortifying admission, nor can 
he be so blind as not to perceive at once, the chief and most potential 
cause which has operated to produce this unfortunate state of things. 

In contemplating this subject, to those who really have the interest of 
our profession at heart, who feel a commendable pride in the calling 
which they have selected, and who honestly and earnestly desire to sus- 
tain that dignity and high standing by which the profession of medicine 
has hitherto been characterized ; two questions naturally present them- 
selves. 1st. What are the causes which have conspired to depreciate 
medical acquirements and professional influence in our country, leveling 
the profession to a trade, and fostering quackery. 2d. By what means 
are we to purge the profession of these evils, and accomplish a reform? 



100 Original Communications. [March, 

To my mind "but little difficulty presents itself in responding to the first 
of these interrogatories. The cause is unfortunately too wide spread and 
apparent, to escape the observation of the most prejudiced and superfi- 
cial observer. The multiplicity of medical schools which exist in our 
country, the low standard of professional attainment recognized by them 
for graduation, and the utter want of preliminary education in a large 
proportion of the medical students who are permitted to graduate, offer, 
in my judgment, a sufficient explanation for the existence of the evils 
above indicated. I might perhaps, add in this connexion, as a collater- 
al cause, the radical and progressive proclivities of the present age. 
That agrarian spirit which, having recently embodied itself in the form 
of a political organization in our country, under the title of " Young 
America," induces every street urchin or illiterate mechanic, to entertain 
the belief that he has not only the unquestionable right to fill, but that 
he is eminently fitted for any station or position in society, without the 
delay, trouble, and expense, of first acquiring an education. Under the 
influence of this pestilential epidemic, which for many years past has 
been sweeping over this country, destroying in its wild career every mon- 
ument of the past, established by the wisdom, prudence, and experience 
of our progenitors ; invading with its disorganizing elements, the sacred 
precincts of religion, philosophy, and science ; seeking to disenthrall its- 
self of all those necessary and conservative restraints imposed by law, 
morals and religion ; acknowledging no obligatory impulse to human ac- 
tions, but individual will, and refusing to recognize the conventional 
rights either of society or of nations — under the baneful influence I say, 
of this spirit, medicine has been forced to succumb, and no longer claims 
with any pretention to justice or truth, for her followers, the appellation 
of " The learned Profession." The day has passed by, when the profes- 
sion of medicine was confined exclusively to the educated classes of society, 
and the honorable title of Doctor, selected to illustrate the pretensions of 
those who professed a knowledge of the science, has become almost a re- 
proach or a synonyme for quack or pretender. In times past, when none 
but educated gentlemen aspired to become professional men, and none 
were permitted to receive the degree of Doctor of Medicine, who had not 
previously obtained a thorough preliminary education, the social posi- 
tion of the medical gentleman was one of influence and honorable distinc- 
tion : dignified with the title of doctor, he found no difficulty in being 
readily admitted to a social equality with the most fastidious and exclu- 
sive. But my dear sir, "tempora mutantur," who are those who now 
compose a large portion of our profession ? What rank do they hold in 



1854.1 Correspondence. 101 

society ? What position do their antecedents and attainments entitle 
them to hold ? As the legitimate result of establishing medical schools 
in almost every village throughout our country, the once honorable pro- 
fession of medicine has, in many instances been degraded to an ignoble 
and dishonest trade. We now see in every direction, school after school 
springing into existence, and entering the market in eager competition for 
public patronage, endeavoring to underbid each other by an unrighteous 
sacrifice of the most sacred interests of the profession to which they be- 
long, and over which they might be regarded as ex-officio guardians. In- 
fluenced in this by considerations of pecuniary gain, or blinded by the 
imaginary importance and distinction attached to the title of professor, 
they seem utterly insensible to the manifest injury which they are thus 
inflicting upon the reputation, standing, and efficiency of the profession 
at large. In support of these strictures upon the present system of me- 
dical education pursued by the Colleges of our country, I would ask if it 
is not a fact, that scores of young men are annually admitted as students 
of medicine, to the lecture rooms of almost every medical institution 
in the country, who have not only never graduated at any literary 
institution, but are actually so ignorant of the very elements of an English 
education, as to be scarcely able to write ten lines of English without 
committing as many orthographical errors ? Illiterate artizans, flattered 
at the idea of, and tempted by the facilities for, becoming professional 
men, abandon their various mechanical pursuits, and without the useless 
delay of acquiring a preliminary education, walk direct into the anatomi- 
cal halls of some College, as fit material to be manufactured in the short 
space of two years, into bona fide doctors of medicine. Now sir, taking 
into consideration the fact, that nearly the entire philological fabric of 
medical science is based upon the Latin and Greek languages, its techni- 
cal nomenclature derived chiefly from the roots of these two languages ; 
is it scarcely possible I ask, for such persons to acquire in the limited 
period of two years, a sufficient knowledge of that science to justify their 
being sent forth to the world as representatives of the medical profession, 
and suitable practical exponents of its principles ? I would not have you 
suppose my dear sir, that I am actuated by a desire to establish for the 
profession of medicine any exclusiveness ; on the contrary, I am willing 
to leave the door wide open— the profession accessible to all classes of 
society ) requiring always that those who aspire to become professional 
men, shall first render themselves worthy of it, by acquiring a preliminary 
education, so that they may come up to the original standard of medical 
science^ and not require it to descend to that of ignorance and empiricism. 



102 Original Communications. [March, 

With regard to the second proposition with which I started, viz : — by 
what means are we to purge the profession of these evils, and effect a re- 
formation, I am not prepared to give so ready a response. Very many dif- 
ficulties infest our pathway and arrest our progress. This subject, as you 
are aware, has for the last two or three years agitated the professional 
mind, and been repeatedly presented for the consideration of the Ameri- 
can Medical Association. So far, however, as my knowledge extends, 
with the exception of a recommendation that the sessions be extended by 
the Colleges, I am not cognizant of any effort which that body has made 
to reform our system of medical education. On the contrary, I despair 
of our ever accomplishing any material reformation through the instru- 
mentality of that Association. The Schools, whose interests it would 
seem are antagonistic to the various systems of reform which have been 
suggested by those not connected with these institutions, have usually 
managed to exercise a controlling influence over the deliberations of that 
body, and will, I fear, always succeed in defeating every proposition, which 
has for its object, the imposition of any restrictions upon the privilege 
which they now enjoy of turning out doctors at the shortest notice, and 
the least trouble. I must confess, that I have been unable to join 
in the huzzahs which are annually shouted in praise of this Association, 
neither have I participated in singing peans or offering ovations to the 
wonderful achievements, in advancing the interests and prosperity of our 
profession, which it is claimed have characterized its proceedings since 
its organization. In canvassing the pretensions set up by those who 
claim so much for the Medical Association, and who expect so much yet 
from it, I ask myself these questions — What apparent influence has the 
Association so far exerted over the medical profession throughout the 
country ? Has there been any improvement in the system of medical 
education ? Have the dignity, standing, and influence of the profession 
been in any degree exalted ? Has any successful, systematic effort, been 
made to root out Quackery ? Has the code of ethics recommended by 
the Association been regarded by the medical profession at large, or even 
observed in its own annual organizations ? To all of these questions I 
feel constrained to reply in the negative, and whilst I am willing to ac- 
knowledge that the operations of the Association may have paved the way 
for future advantage to the profession at large, candor compels me to 
admit that in my humble judgment, it has so far made but little progress 
towards accomplishing any of the most important and essential objects 
for which I presume it was instituted. So long as the licensing power 
rests exclusively with the irresponsible faculties of the Medical Schools, 



1854.] Biography. l^S 

60 long will thfe selfish dictates of interest triumph over duty to the pro- 
fession, and induce them to graduate those who are manifestly incompe- 
tent and entirely unworthy to become members of the medical profes- 
sion. 

Hoping that you will excuse the hasty and loose style in which I have 
hurriedly written this, I subscribe myself very truly and respectfully 

Yours, 

J ' ALEX'R. Y. P. GARNETT. 



BIOGRAPHY. 



Biographical Notice of the late Professor Horner. 

We presume that most of our readers have known Dr. Horner : proba- 
bly most of them have listened to his instructions, and all, have no doubt 
been familiar with his writings, and none will turn an unwilling eye from 
the page that records a brief reference to the history of this truly esti- 
mable man. 

Dr. Horner was a native of Virginia. He was born at Warrenton, 
Fauquier county, on the 3d of June, 1793. His constitution being ex- 
ceedingly feeble in boyhood; he was very spare, and weighed not more 
than 961bs. when near adult age. 

He was thus prevented from indulging in the usual sports of early life, 
and spent his time in the company of his elders, and the improving em- 
ployment of reading. His education was mainly conducted by a clergy- 
man in his native town, and at an academy in Dumfries. 

He commenced his medical studies in 1809, under the direction of Dr. 
John Spense, a Scotch physician, educated in Edinburgh, with whom he 
continued till 1812, during which period he attended two courses at the 
University of Pennsylvania, paying particular attention to anatomy. 

In 1813, (before he graduated) he received a commission as Surgeon's 
mate in the hospital department of the U. S. army, which, he accepted. 
In Sept. following, he was attached to the 9th military district, north of 
the Highlands, state of New York, while in his twentieth year, being in 
the receipt of some thirty or forty dollars per month, and rations. He 
was ordered to take charge of seventy-three invalids at Greenbush, some 
of whom had been severely wounded at the capture of Yorktown and fort 
St. George. After relinquishing his command at Greenbush, he hasten- 
ed to Philadelphia to attend the winter courses at the University, and 
graduated in April 1814. In June following, Dr. H. reached the frontier 
and was attached to the hospital at Buffalo, where he was faithful in re- 
lieving the many sufferers who were brought to the hospital from the en- 
gagements of Fort Erie and Chippewa, in July following, so that he had 
under his professional charge at one time, 175 wounded and sick. Hie 
tour of duty on the Niagara frontier was concluded on the 24th Decern- 



101 Original Communications. [March, 

ber, and in his Journal is found the following record — " I was the first 
on the ground, and am the last to quit it." He was afterwards station- 
ed at Norfolk, Virginia, and on the receipt, at Washington, Feb. 15, 
1815, of the intelligence of the signing of the treaty of peace at Ghent, 
he determined to resign his commission, which he did on the 13th of 
March following. On the 23d, he received information of its acceptance, 
and left Norfolk on the following day, for his paternal home. He settled 
for a short time at Warrenton, but could not remain long. He was mo- 
ved by a secret impulse, to seek the scene of his future prosperity. His 
journal makes this record on the 3d of December 1815 — "The Rubicon 
is passed. I have forsaken my relatives, my friends, and my practice. 
I am now on my way to Philadelphia, where I intend to seek my for- 
tune. I have put all at hazard. 0, thou eternal Father, the giver of 
all good gifts ! may Thy blessing attend me." 

He spent the winter at the University, prosecuting practical anatomy : 
his enthusiasm in this branch of study, his quiet demeanor, his steady, 
patient perseverance, attracted the notice, and earned the friendship of 
Prof. Wistar, who offered in the following March to appoint him his dis- 
sector, at a salary of $500 per year. The offer was accepted, and Dr. H. 
proceeded to his duties. In the fall he was offered a Surgeon's place on 
board an East Indiaman, but in consequence of his engagement with Dr. 
Wistar, he promptly declined. On noting this occurrence in his diary, 
he remarks : 

"It is said that the fortune of every man depends on some unexpected circum- 
stance ; I may have rejected that on which my fortune turned. My refusal arose 
from my sense of obligation and honorable intentions to Dr. Wistar. There is a maxim 
that ' honesty is the best polit-y.' I now put it to the test." A note is appended to 
this passage, dated January, 1852, to this effect ; " See vote of Trustees of the Univer- 
sity of Pennsylvania, appointing me Professor of Anatomy, November, 1831." 

In 1818, Wistar died, and Horner records this, to him afflicting dis- 
pensation, " my friend, my patron, my example in life, the good, the il- 
lustrious Wistar is no more. My hopes are again destroyed" Dorsey 
succeeded to the chair of anatomy, and appointed Horner as his demon- 
strator, placing the dissecting class, and all its emoluments in his hands. 
In 1818, the anatomical course was opened by Dorsey with one of the 
most brilliant introductories ever listened to within these walls, but that 
very night he was taken ill, and in a few days was carried to the grave. 
Horner again desponded, but Physick, who took upon himself the ana- 
tomical department, renewed with him the arrangement made by his pre- 
decessor. In Oct. 1820, Dr. H. was married, and in the month succeed- 
ing, he was associated with Dr. Physick, as adjunct Professor of Anatomy. 

li In 1823 he was appointed one of the Surgeons to the Philadelphia Almshouse 
Hospital, which office he held for twenty-five years. 

" Dr. Physick, broken down by increasing infirmities, finding the task of lecturing 
beyond his powers, resigned his chair in 1831. 

" Dr. Horner, in November of that year, was unanimously elected in his place. 

"Onthe approach of the cholera invasion of 1832,the city Councils appointed a San- 
atory Board, composed of the principal physicians of the city. Dr. Horner was one of 
those elected ; and was subsequently placed in charge of one of the temporary dis- 
trict hospitals, established during the prevalence of the epidemic. 

"He devoted himself to investigate the anatomical lesions that occur in the intesti- 



1854.] Biography. 105 

nal tube in cholera. For this object he adopted an entirely new method of observa- 
tion. He first made a minute injection of the mucous membrane, and then examined 
it under water, with large magnifying lenses ; and afterwards on the object-glass of 
the microscope. 

"In this manner, he demonstrated that the epithelial structure of the small intestines 
is destroyed, and desquamated." 

In 1849, he succeeded in founding St. Joseph's Hospital. His health 
began to fail in 1841. Hypertrophy of the heart became evident in 1844. 
In 1847 dropsical effusions commenced. In 1848, accompanied by his 
friend Dr. Leidy, he made the tour of Europe ; visiting hospitals in En- 
gland, G-ermany and France, with all the ardor of a young professional 
tourist. He returned, much benefited in health, and followed the routine 
of his duties until the winter of 1852-53. In November 1853 he was 
obliged to leave the city on account of ill health, but returned in a few 
weeks, and continued his lectures till the 27th of January. 

" This last lecture was accomplished with difficulty. His limbs were distended 
with dropsical swellings; for a week he had been lecturing, while bandaged to the 
waist ; his respiration labored and short, rendered speech difficult , the heaving heart 
and throbbing carotids, seemed threatening every moment an apoplectic hemorrhage, 
a sudden congestion, or fatal effusion on the lungs. At the end of the lecture he de- 
liberately walked to his home, at least a quarter of a mile, as though he were in per- 
fect health. From this time he felt the conviction that his office in life was closed, 
and he was soon to be removed from those duties which he had fulfilled with earnest- 
ness and integrity. He resigned himself calmly to his fate, and awaited its coming 
without a murmur, or with reluctance. There was, with him, no parade of prepara- 
tion for a future state, for it had been the ruling thought and aim of his whole life. He 
seldom talked of his death, but, when it was alluded to, it was treated and spoken of, 
as any other occurrence of our daily life. A circumstance I am tempted to mention, 
shows his coolness and unconcern on this subject. He was lying on a couch — Dr. 
Henry H. Smith and myself sitting on each side. Doctor Horner was suffering some 
pain, a new symptom that had just commenced. He demonstrated with his finger the 
different regions of the trunk, enumerating the organs they contained, and the state of 
each, and indicated the exact seat where he then suffered the most. This was done 
with the interest and earnest manner of a demonstration to his class. I was so struck 
with it, as to call the attention of Doctor Smith to this display of the "ruling passion 
strong in death." "Look! here is the anatomist dissecting his body — making a post 
mortem before he is dead." The remark so amused Doctor Horner, that he laughed 
heartily, in which we joined him. At the end he said : " Well, I have not had so good 
a laugh for a long time." This occurred on the third day before his death. 

" The imperative sense of duty, so conspicuous a trait in Doctor Horner, was mani- 
fested in the last moments of his life. Towards the close of February, finding the 
most urgent symptoms of his case mitigated, and his life prolonged beyond his expect- 
ations, he insisted on relieving the Faculty of the University of a portion of the labors 
his incapacitated state might throw on them. He commenced the anatomical exami- 
nation of the candidates for graduation, aided by his son-in-law, Doctor Henry H. 
Smith, and continued this duty until within two days of his death. 

" It is somewhat remarkable that the death of Doctor Horner was not the immedi- 
ate result of the chronic affection under which his constitution had broken down. He 
had complained about the 10th of March, of pain in the abdomen, on the left side. 
The night of the 12th it suddenly assumed an intensity that led to the suspicion of 
peritonitis from a perforation. He sank exhausted by unceasing and unmitigable suf- 
fering the evening of the next day, March 13, surrounded by his sorrowing family and 
relatives. 

"Examination after death, revealed the existence of entero-peritonitis, with mortifi- 
cation of the small intestines. This new condition was the direct cause of death, and 
had suddenly supervened on the original disease." — Compiled from Professor Jackson's 
Discourse. 

14 



106 Bibliographical Notices. [March, 



BIBLIOGRAPHICAL NOTICES. 



HOMOEOPATHY : its Tenets and Tendencies, Theoretical, Theological and 
Therapeutical By James Y. Simpson, M. D., &c. &c. Philadelphia. 
Lindsay and Blakiston, 1854. (8vo. pp. 304.) 

What is the duty of the medical man with regard to empiricism and 
pseudo-science ? What is the position which the conscientious physician, 
for the sake of truth and humanity, should assume toward them ? These 
are difficult questions, and have always been answered differently by dif- 
ferent classes of minds in the profession. Nor are they yet settled. Ad- 
huc subjudice his est, may he truly said, for opinions on the subject are 
as widely divided now, as ever. With regard to bold and barefaced 
quackery, (such as that which has recently established its head-quarters 
at the capitol of our state), there is of course but one sentiment. To that 
sort of thing the profession can know only the one relation — that of war 
to the bitter end. Neither does it expect any thing else, being openly 
blatant and defiant, and relying solely on its appeal to ignorant credulity. 
The difficulty is to know how to treat those more insidious forms of em- 
piricism, which come in the guise of " New Systems," or professed " Me- 
dical Reforms/' based upon specious arguments, that seem plausible 
enough to the unprofessional persons to whom alone they are addressed. 
Shall they be met with argument and exposure? or is it wiser to let 
them alone, confident that they will die out of themselves ? We confess 
that we have always inclined to the latter opinion. In a case where the 
sentiment of the profession itself is divided, we can understand the value 
of free discussion and examination, but in the instances to which we now 
refer, the appeal is made to an uneducated public, totally unable to ap- 
preciate the first elements of the controversy. Every physician must re- 
call with a smile, the extraordinary, and often ludicrously absurd " argu- 
ments'' they have heard adduced, in support of homoeopathy and kindred 
delusions, by persons otherwise sufficiently intelligent. A discussion be- 
fore such a tribunal, is very apt to become a sort of game of " brag," in 
which the umpires will be carried away by the disputant who indulges in 
the boldest and most reckless impudence of assertion. We have always 
been convinced, moreover, that irregulars of all sorts gained additional 
notoriety and consequence from professional notice. Hence comes the 



1854.] Bibliographical Notices. 107 

zeal with which they seem to solicit, and endeavor to provoke attack. Like 
Mawworm in the play, they " love to be despised," because it gives them 
ground for an appeal to popular sympathy. As concerns homoeopathy 
at present, we have thought it bad policy to assail it, because it is dying 
out fast enough of itself. All false systems are necessarily short-lived, and 
this one, having passed its culminating point, is rapidly falling into the 
condition of confusion and self-stultification that precedes dissolution. 

Dr. Simpson, however, is of the contrary sentiment. He believes that 
the quasi-scientific empiric should be met with a thorough and searching 
examination of his pretensions. Every new " system" he would subject 
to the test of a rigid analysis, exposing its sophistries, and laying bare 
its absurdities. This he has attempted for homoeopathy in the present 
work. While doubting the policy of the proceeding, we nevertheless re- 
joice, that it has fallen into such able hands. There is no clearer head, 
and no more fluent pen in the profession, than Dr. Simpson's. This 
volume, which is a reprint of his third Edinburgh edition, contains a full 
and candid statement of the homoeopathic doctrines and practice, extract- 
ed from their highest authorities, and commented upon in a spirit of 
kindly, but at the same time, of logically severe criticism. Each propo- 
sition is fully considered and amply illustrated, and its fallacies exposed. 
There are portions of the subject so absurd intrinsically, that it is almost 
impossible to discuss them with becoming gravity, but even over these 
Dr. S. has managed to restrain his risibilities, and preserve proper deco- 
rum. His book is a thorough exposition of the whole matter, and will 
hereafter be invaluable to the student of medical history. We cordially 
recommend it to all who desire to know what homoeopathy is, and what 
are its tendencies. We are also glad to see that Dr. S. includes in this 
edition, a synopsis of Dr. Graidner's masterly exposure of the fallacy of 
homoeopathic hospital reports. 

From the chapter which treats of the present condition of homoeopathy 
on the continent of Europe, we make the following extract, the interest 
of which will excuse its length. 

" In c Bradshaw's Guide to the Continent,' published a few months ago, (August, 
1851,) the author, Mr. Lee, who, 'by repeated visits and residences' upon the conti- 
nent, has made himself specially intimate with its medical and other institutions, inci- 
dentally makes the following observations regarding the present state of homceopathy 
in its native country of Germany, and the condition of it in Leipsic at the time of his 
last visit to that city : 

" At that time," he observes, (pp. 290 and 291) « of my first visit, I was anxious to 
see the homoeopathic Hospital, of which I had previously heard, Leipsic being head- 
quarters of this doctrine, I expected to have found at least forty or fifty beds filled with 



108 Bibliographical Notices. [March, 

patients ; but was rather surprised to find that the building (which is a small house in 
the suburbs) only contained eight, and even of these, all but two or three were unoG- 
cupied. At my last visit to LeipsiC, I understood that matters were going on badly 
with homoeopathy, which indeed, is now comparatively little heard of in Germany and 
France, except at Vienna, and only requires to be understood by the public for its ab- 
surdity to be apparent, though there will always be credulous individuals who are to 
be caught by any novelty, when presented under a specious appearance, and backed 
by an unintelligible name. During its whole progress, it never was sanctioned by any 
individual of eminence in the profession, and was principally taken up as a means of 
acquiring wealth or a livelihood, by persons who had never been previously heard 
of, or who were known as having failed to acquire practice by the honorable exercise 
of their profession, by whom every means were taken to puff it into notice, and to 
keep public attention directed to it ; such as repeated histories of cures, the establish- 
ment of dispensaries, of which I believe, the only one that remains, is the above men- 
tioned, at Leipsic, even if that be still in existence ; for a few months before my arri- 
val, the house-physician having become convinced during a residence of sometime in 
the dispensary, of the nullity and danger of homoeopathy, gave up his appointment 
and published an exposition of the system pursued, with an account of cases, which 
clearly shows (what had long been evident to the bulk of the profession and the pub- 
lic), that the so called cures were recoveries from ordinary ailments, by the efforts of 
nature, which were frequently a long time under treatment: whereas, by a proper 
medication and attention at the outset, they might probably have been removed in a 
few days ; and that many of the more serious cases got worse instead of better, for the 
want of active treatment. It must not be supposed that the homceopathists always 
adhere to the principles of the doctrine. It has not unfrequently happened, that per- 
sons who attributed their recovery to homoeopathy, were treated allopathically with- 
out their being aware of it. In fact, one practitioner in Leipsic, a professed homceo- 
pathist, candidly acknowledged that he pursued both plans of treatment, and was ac- 
customed to ask his patients by which method they would be treated, as both were 
equally good. 

" Within the last few weeks I have been informed by Dr. George Fleming, of Dun- 
dee, who has just returned from a six month's sojourn at Vienna, that he attended the 
homoeopathic hospital there, under Dr. Wurm, for upwards of a month, but that mat- 
ters did not seem to go on prosperously with homoeopathy, even in that school, which 
is acknowledged to be its central and ehief seal; the whole number of pupils in at- 
tendance at the hospital only amounting to five. The diseases of the patients were 
chiefly of a chronic and subacute type, with numerous cases of a prevailing mucous 
fever, which was so slight as not to require formal medical treatment. Only one case 
of acute inflammatory disease, was admitted, viz: a case of pneumonia of four days 
standing. This patient died. 

"There is a second and older homoeopathic hosptial at Gumpendorf, in the suburbs 
of Vienna, under the medical charge of Dr. FJeischmann. When Dr. Fleming was at 
Vienna, he was assured that there was only one medical pupil attending Dr. Fleisch- 
mann's hospital. His informant was the pupil himself. Speaking of Fleischmann's 
hospital, Dr. Routh, who sometime ago studied at Vienna, remarks 'I never saw at 
any one time, more than two students in attendance, besides the physician going 
round.' 

"In a letter lying before me, from Dr. Gerson, a very intelligent young German 
physician, who has studied at various continental schools, and has lately come on a 
visit to Edinburgh, it is stated, ' during the last six or eight years, neither the medical 



1854.] Bibliographical Notices. 109 

profession nor the public of Germany have paid any degree of attention to homoeopa- 
thy, for it is now everywhere looked upon as possessing no theoretical or practical 
value. It is tolerated, because it is regarded as a very innocent and harmless species 
of quackery. * * As regards actual homoeopatic practice in Germany, it is very 
limited indeed in Leipsic, where the English and other admirers of Hahnemann, have 
lately erected a statue of him, and which was once the chief seat, if not the birth-place 
of homoeopathy. Out of 120 medical men, there are now, as I was lately informed by 
Dr. Radius, the Professor of clinical medicine in the University of that city, only six 
or seven homceopathists, and only two or three of this number can be said to be enga- 
ged in practice, and to a limited extent. The homoeopathic hospital which existed 
formerly in Leipsic, has become defunct. In Hamburg, out of 1S3 medical men, there, 
is now only one homoeopathist. The son of this gentleman has entered the medical 
profession, but has not adopted the homoeopathic principles of his father. A physician 
who formerly practised homoeopathy in Hamburg, renounced it some years ago, and 
returned to legitimate medicine. 

" While this sheet was passing through the press, Dr. Oscar Prieger, of Kreuznaeh, 
a physician well known to many English invalids who have of late years visited the 
continent, came to Edinburgh ; and, on showing him Dr. Gerson's letter, he confirmed 
to me in the strongest manner, the recent rapid decline, or indeed total extinction of 
homoeopathy in the cities and medical schools along the Rhine, and in all that part of 
Germany with which he was acquainted. In fact he had heard the word only in En- 
gland, or from English patients, during the last five or six years ; — the delusion having 
now altogether ceased to excite any interest in the districts of Germany with which 
he was intimate." pp. 43 — 47. 

We are satisfied that the homoeopathic delusion is equally on the de- 
cline on this side of the Atlantic. Every practitioner must see that it ob- 
trudes itself upon professional attention less and less every year. Certairi 
neighborhoods may still be troubled with an occasional outbreak of ex- 
citement on the subject, but it certainly attracts much less of popular 
notice. In Philadelphia, where it was originally mainly confined to the 
German population, it is now very rare for a German family to employ a 
homoeopath. It is also to be observed that most of the recent candidates for 
popular favor in this line, associate with it the practice of hydropathy or 
mesmerism, or more rationally, of electro-magnetism. The original pro- 
fessors of pure Hahnemannism (of whom there is merely a remnant left),' 
are fading into obscurity, and their place is taken by men who notori- 
ously use heroic doses of the alkaloids, and whatever else can be smug- 
gled into a globule, or a moderate sized powder. Dr. Simpson mentions 
the case of the Due di Canizzaro, who died after taking a dose of homoe- 
opathic globules, with all the evidence of poisoning by strychnia. A 
similar case recently occurred in New York. Dr. Alfred Taylor, of Lon- 
don, found one third of a grain of sulphate of morphia in a single " ho- 
moeopathic' ' powder. A patient to whom the writer gave veratria in the 
dose of i of a grain ; thrice daily, exclaimed that we had given her " ho- 



110 Bibliographical Notices * [March, 

moeopathie" medicine, which she recognized by the same pricking sensa- 
tion of her fingers and toes. One of the most successful practitioners of 
the art, now in Philadaelphia, uses only tinctures, which he inspissates to 
some fanciful standard of his own, and then gives, dropped on sugar in the 
form of powder. His apothecary informs us that this person purchases 
largely of the solaneous narcotics, and of the Tr. Aconiti several quarts 
annually. We were sometime since called to see an old lady suffering 
with anasarca from heart disease, who had been under the care of a con- 
sultation of nominal homoeopathists. She complained much of the "nas- 
tiness" of their medicine, so contrary to her previous notions. On ex- 
amination we found her powders to contain each, about 5grs. nitrate po- 
tassa, and lgr. powdered digitalis, with some sugar ! Evidently, the 
majority of these practitioners at present, are mere impostors, who avail 
themselves of the popular delusion to obtain patients, and then endeavor 
to secure some efficacy in practice, by secretly using the armory of legiti- 
mate medicine. Evidently, moreover, such a state of things cannot last 
long. Homoeopathy is ready to die the moment its fit successor comes, but 
not till then, for there is a class in the community that cannot live with- 
out a quackery to foster. In the meantime, let every one who desires to 
be either instructed or amused concerning it, avail himself of the admi- 
rable labors of Dr. Simpson. 

Clinical Report on Dysentery; based on an analysis of forty-nine 
cases, with remarks on the Causation, Pathology and Management of 
the Disease. By Austin Flint, M. D. Buffalo ; Jewett, Thomas & 
Co., 1853, (8vo. pp. 90.) 

Clinical Report on Chronic Pleurisy; based on an analysis of 
forty-seven cases. By A. Flint, M.- D. Buffalo ; Jewett, Thomas & 
Co., 1853, (8 vo. pp. 58).* 

It will be perceived that our table this month is unusually rich in 
works of a practical character, and addressed to the mature practical mind 
of the profession. This is a gratifying fact, as evidencing that we are 
passing out of the era of text-books into that of a more manly literature. 
Many of us (not old fellows either), can remember when it was rare to 
see in a Doctor's office, any book of higher grade than the manuals he 
used at College. Now, however, this "niilk for babes" will no longer 
answer for his grown estate. He requires something more direct, sub- 
stantial and practical, and our enterprising publishing houses (as our list 

*For copies of these works we are indebted to Mr. H. C. Morton of Louisville, Ky., 
by whom they are for sale. 



1854.] Bibliographical Notices. Ill 

fully demonstrates), stand ready to supply his wants. It is undeniable, 
that the body of our profession read ten times as much as they did thirty 
years ago; and with this increased intelligence there comes an increased 
practical efficiency, which the public will not be slow to appreciate. One 
great advantage resulting from this change, is the adoption of a less ex- 
alted style by medical writers generally. They have laid aside the pro- 
fessorial tone, and instead of lecturing ex cathedra to submissive pupils, 
they write as men addressing their peers. Boldness of assertion, and 
looseness of statement, are instinctively repressed, in a production to be 
submitted to the ripe judgment of the experienced. We therefore hail 
with pleasure the appearance of such works, although, as in the present 
instance, they may not altogether agree with our views. 

The first mentioned volume, is a reprint of a series of papers that origi- 
ginally appeared in the Buffalo Medical Journal, and wherein the author 
endeavors to illustrate the general subject of dysentery according to the 
statistical or numerical method. We confess to a daily diminishing faith 
in the value of medical statistics. It may be that " figures cannot lie," 
but unfortunately medical language is generally so loose and unprecise, 
that there is always a doubt as to what exactly the figures apply. For 
instance, we are told that on a certain occasion, one hundred cases of 
Cholera all recovered under Homoeopathic treatment ! But what idea is 
conveyed to the homoeopathic mind by the word cholera ? Doubtless the 
hundred patients mentioned had diarrhoea and perhaps vomiting, but, as 
for cholera, — it's another matter. Or, we may be assured, that in a cer- 
tain epidemic of Scarlatina, twenty-five consecutive cases were cured by 
Dr. Somebody with lard inunctions. Yet every physician who has gone 
through several such epidemics, knows that it is an even chance, whether 
next season, twenty-five consecutive cases die under lard inunction, or 
twenty-five recover without it ; not that the lard is useless, but it is by 
no means a specific. The disease this year may have an intensity un- 
known the last. To come from these extreme cases to others, where the 
greatest accuracy is attempted, there will always be some of the same un- 
certainty. The result in a given case, will depend perhaps as much upon 
the grade of intensity of the attack, and the individual peculiarities of 
the patient, as upon his treatment. No tabular statement can include all 
these elements, which are indispensable in the examination of any limited 
series. But they are partial and restricted in their operation, and, in 
any very extended series, may be safely left to balance one another. 
Hence statistical results, covering a very wide field of observation, give 
us an approximation to the truth, whose value increases in a much 



112 Bibliographical Notices. [March s 

more rapid ratio than that of the numbers themselves. We therefore at- 
tach a value to such statistics, which we deny to a numerical analysis of 
a small number of cases. In the present instance, we hold that Dr. Flint's 
basis is too narrow for his attempt. "We must do him the justice, how- 
ever, to say, that he has performed his task generally with logical consis- 
tency, and all possible precision. As he has confined himself rigidly to 
the phenomena observed in his cases only, the reader must not expect a 
full history of dysentery in all its modifications. But we apprehend that 
Dr. F. has, in one or two instances, ventured into assertion beyond what 
his record justifies. If he means simply to assert, that none of his forty- 
nine cases presented the symptoms of what we are in the habit of calling 
bilious dysentery, he is doubtless correct. But we understand him to. 
deny the existence of that form of the affection, of which we are as inti- 
mately convinced, as we are of the existence of autumnal fever itself. 
We have seen three forms of Dysentery : 1st. pure sporadic, or simple 
colonitis ; 2d, epidemic, prevailing over wide regions of country, and 
with an unmistakeable typhous tendency, 3d. endemic, confined to our 
river-bottoms and similar miasmatic localities, and with the hepatic com- 
plication obvious at first sight. In the two first classes, the use of calomel 
is of at least doubtful propriety, while the third cannot possibly be ade- 
quately treated without it. Whoever observes the above distinctions, 
will also know when to use the lancet, and when it must be carefully 
avoided. We are inclined to believe, moreover, that the apparent con- 
tradiction in the reports of the County Medical Societies of Pennsylva- 
nia, as to the geological formations over which dysentery prevails epi- 
demically, may easily be reconciled by keeping this in mind. The great 
majority represent that the epidemic occurs upon gravel or slate forma- 
tion, (frequently high ridges,) while the adjacent limestone districts are 
exempt. Certain exceptions are reported, but these (as far as we are 
acquainted with their topography) are all river-valleys, notoriously sub- 
ject to pernicious forms of malarious disease. Compare the cases in the 
two localities, and we venture to predict, that they will be found entirely 
different. We regret that the experience of Dr. F., has not called his 
attention to this interesting distinction, for it demands elucidation at the 
hands of just such a cautious and conscientious observer as he appears to 
be. It would have enabled him, moreover, to give a clearer notion of 
the use of calomel than he has done. 

On the whole, his remarks on treatment are satisfactory. He 
uses one phrase, however, against which we must always protest, espe- 
cially as he is right in his opinion, and merely uses it from habit. 



1854.} Bibliographical Notices. 113 

We refer to a purging in dysentery." The word purging always 
conveys the idea of drastic catharsis, and is therefore liable to lead 
into fatal errors of practice. Dr. F. uses only " laxatives in dysen- 
tery," and should say so, distinctly. There is a tendency to torpor of the 
upper bowels and foecal accumulation, notwithstanding the constant tenes- 
mus, and the relief which follows a free evacuation is sometimes surprising. 
The periodical use of a laxative, is especially necessary where opium and as- 
tringents are given by the mouth. For this purpose Dr. F. prefers 
castor eil. He speaks doubtingly of the usefulness of the saline cathar- 
tics, which we wish he had condemned more pointedly. Acting almost 
entirely on the upper bowels and causing liquid stools, they may be be- 
neficial if administered with extreme care, and in very small doses, but 
they are liable to irritate and do mischief. The blandest obtainable oily 
matter, presents that combination of laxative and demulcent effect which 
the case demands. We have occasionally used almond and olive oil, 
when perfectly sweet, with excellent effect, but melted butter answers so 
much better than anything else, that we have for years past, relied en- 
tirely upon it. It has been our habit, where it was practicable, to have 
it churned for each occasion, and given immediately, melted by warm wa- 
ter, in doses of ^ss — j. If overheated, or burned, in melting, it is apt to 
occasion heart-burn and unpleasant eructations. 

The remaining essay of Dr. F. is, to our minds, a more satisfactory pro- 
duction than that just noticed. The number of cases seems less inade- 
quate, considering the comparative infrequency of Ohronic Pleurisy. 
His materials, moreover, are more thoroughly digested, and we have read 
the work with interest and instruction. We shall always welcome the 
appearance of Dr. F., in the arena of medical literature, where his name 
is becoming familiar ; and of one thing he may rest assured so long as we 
fill a chair editorial :— if we differ from him in sentiment we will certainly 
tell him of it, though always, we trust, Jdndly and respectfully. 

On the Etiology, Pathology, and Treatment of Fibro-Bronchitis and 
Rheumatic Pneumonia. By Thomas H. Buckler, M. D., &c. 
Philadelphia, Blanchard & Lea, ^L853, (8vo. pp. 150.) 

The author of this interesting work frankly informs his readers at the 
outset, that this is one of the rejected candidates for the prize of 
the American Medical Association, in 1853. But it is none the less 
valuable on that account. We can perceive its faults, which concern ar- 
rangement and style, while the matter we have found extremely interest- 
ing. Dr. B. deserves the thanks of the profession for his investigation 
of a hitherto neglected topic, which must lead to important therapeutic 
results. The disease which he describes, is Fibro-bronchitis, or rheuma- 

1r ' ' 





114 Bibliographical Notices. [March, 

tic inflammation of the fibrocartilaginous structure of the bronchia, as 
distinguished from the mucous tissue. It is one which, although occa- 
sionally hinted at in medical literature, is passed over in silence by 
systematic writers, and is entirely ignored by our modern practical au- 
thorities. Yet we venture to assert, that no experienced practitioner 
can read Dr. B's. book, without having a flood of light thrown upon a 
a host of "dry catarrhs," as well as upon the course of certain obscure 
chronic pulmonary affections. The chapter on the Rheumatic Element, 
will be found especially valuable. Dr. B., divides all rheumatisms into 
four classes, the first and most common of which, is that dependent upon 
the presence of lithic acid and lithate of soda in the blood. It is in this 
form that he relies upon Phosphate of Ammonia, of the superior efficacy 
of which, he seems quite as confident now as he was, when he first pub- 
lished on the subject, some ten years ago. The second form depends 
upon the retention of nitrogenous matter in the blood, from suppressed 
perspiration, — the third upon the abnormal presence in that fluid of 
earthy phosphates, — and the fourth upon the retention of certain illy- 
understood "extractive matters" of the urine. All these of course re- 
quire diversities of treatment ; but all are liable to be complicated with 
bronchitis. The cases illustrative of Dr. B's. treatment, are reported at 
greater length than seems to us essential, but it is better to err upon that 
side than the other. The concluding chapter on Treatment, is full of 
sound practical suggestions, which make this eminently a book to be 
prized by the "working doctor," rather that the mere closet student. 



On the Use and Abuse op Alcoholic Liquors, in Health and Dis- 
ease. By Wm. B. Carpenter, M. D., with a preface by D. F. Con- 
die, M. D. Philadelphia, Blanchard and Lea, 1853. (8vo. pp. 178.) 

Messrs. Blanchard and Lea have given us a neat edition of the cele- 
brated prize essay of Dr. Carpenter, intended for general, as well as pro- 
fessional use. It is preceded by a highly laudatory preface from the pen 
of Dr. Condie, who has also appended to each page a glossary of notes, 
explaining terms otherwise unintelligible to the unprofessionable reader. 
The work of Dr. Carpenter is able and learned, and is written in a pure- 
ly scientific spirit, without prejudice and without fanaticism. He demon- 
strates beyond dispute, the injurious effects of alcohol upon the healthy 
system, and shows that the cases of disease in wich it can be useful, must 
be exceptional and very rare. The book will be found a rich storehouse 
of facts and arguments for the advocates of total abstinence. 



Elementary Chemistry, Theoretical and Practical. By George 
Fownes, F. R. S. &c. Edited with additions by B. Bridges, M. D. &c. 
Philadelphia, Blanchard and Lea, 1853, (12mo. pp. 555.) 

This is another edition of a well-known and favorite work. It i& 
brought up fully to the mark of present science — notwithstanding the 
lamented death of its author — by the labors of Drs. Hoffman and Bence 
Jones. We know of no better text-booky especially in the difficult de- 



1854.] Bibliographical Notices. 115 

partment of organic chemistry, upon which it is particularly full and sa- 
tisfactory. We would recommend it to preceptors as a capital " office 
book" for their students who are beginners in chemistry. It is copious- 
ly illustrated with excellent wood cuts, and is altogether admirably 
" got up." 

WORKS IN PRESS. 

One object we have proposed to ourselves in the conducting of this 
Journal, is to keep our readers apprized of what books are forthcoming 
from the American press. This can be accomplished only by a co-ope- 
ration with the publishers generally, which it will require time to organize. 
This month, therefore, our list is rather meagre, yet we are able to an- 
nounce some things which will awaken a pleasant anticipation. Thus; 
BlaDchard and Lea promise us speedily, a "Treatise on Chronic Diseases 
of the neck of the uterus," from Prof. Meigs, whose works are always 
received with delight. It will be illustrated by colored plates. The same 
publishers have nearly ready " Erichson's Science and Art of Surgery," 
with over 300 wood cuts. This will be followed by "Abel and Bloxam's 
Practical Chemistry," also copiously illustrated. 

The interest in uterine pathology is well sustained, judging by the 
number of works upon it which find a ready sale. S. S. and W. Wood, 
of New York, announce another in " Jobert on Diseases of the Uterus," a 
work of high rank, and which we rejoice to see made accessible to the 
American reader. They also have in press Dr. Neligan's "Atlas of Cu- 
taneous Eruptions," containing nearly 100 delineations, arranged in six- 
teen colored folio plates. 

Lippincott, Granibo and Co., of Philadelphia, advertise a translation, 
by Dr. Da Costa, of " Kolliker's Microscopical Anatomy of the Human 
Body," with over 300 wood cuts. The work is one much needed by the 
medical public at present, and as its author's name is of the very highest 
authority in these matters, its appearance will be looked for with interest. 
The same firm also announce a new edition of " Morton's Anatomy." 
Among books not strictly medical, they have in preparation a really 
great work on Ethnology, by Dr. J. C. Nott, of Mobile, and George B. 
Gliddon, Esq., formerly our Consul at Cairo, entitled " Types of Man- 
kind." Our readers are aware that the subject of the origin of human 
races has been discussed of late years with considerable warmth. The 
writers of the present volume are among those who contend for nume- 
rous races and separate origins. They bring to their task immense learn- 
ing and research. In the palgeontological department, they are assisted 
by Dr. Usher, of Mobile while Prof. Agassiz contributes a profound es- 
say on "Centres of Creation," illustrated by a beautiful colored tableau. 
The work is dedicated to the memory of Samuel George Morton, 
whose disciples the authors profess to be, and is preceded by a memoir 
of that distinguished savant from the pen of his friend Dr. H. S. Patter- 
son, of Philadelphia. The whole will constitute a quarto volume of 750 
pages, with about 350 wood cuts, and numerous lithographic plates and 
charts. 



11$ Editorial, [March, 



EDITORIAL. 



MEDICAL SOCIETY OF NEW JERSEY. 

Our readers will perceive that tlie present number of the Reporter 
contains a large amount of extra matter in the shape of the Transactions 
of the Medical Society of New Jersey. 

We feel assured that these transactions will repay a careful perusal. 
The minutes will show, that the profession of our State is not indifferent 
to the subject of progress ; and yet we could wish to see more zeal and, 
disinterestedness manifested, in the increase of the budget of the Stand- 
ing Committee, and in the presentation of voluntary essays and commu- 
nications. 

Much of the time of the Society was lost, for want of a proper atten- 
tion on the part of the members, to parliamentary usages. We hope 
there will be an improvement in this respect, in future meetings. A 
case of discipline also consumed much time, and was finally, much to the 
regret of the members, unavoidably postponed for a year. The attend- 
ance of members Was not large, yet the different sections of the State 
were tolerably well represented. 

As the Transactions of the Society are becoming year by year more 
voluminous, and the expense of publishing them, increases correspond- 
ingly, we suggest the propriety of appointing a Committee of Publication, 
whose duty it shall be to have the oversight of publishing the proceedings. 
This burden should not fall so much on one or two individuals. The ap- 
propriation made this year, for the purpose, is not nearly sufficient. 
This whole matter should be in the hands of a competent Committee. 

We are very glad that the Society has resolved to re-establish the old 
custom of having the members dine together. There is no doubt, that 
this will render our meetings more sociable and pleasant. It will also fa- 
cilitate business, by preventing the members from becoming scattered. 

There are indications that the profession of the State- — especially the 
younger portion of it) is becoming more and more interested in our-me- 
dical organizations. We are glad to see this, as it bespeaks an increas- 
ing desire to advance the interests of mankind, as represented in the pro- 
gress of medical science. 



1854.] Editorial 117 

CORRESPONDENCE. 

In our correspondence department will be found two letters called 
forth by an essay in the last number of the Reporter entitled " Doc- 
tors* Commons." The suggestion of "M. D. Jr.," is a good one, and 
might easily be carried out to the manifest advantage of both practitioner 
and patient. Such a " League" as he proposes, has for some time been 
in successful operation in Burlington, and is found to work well. Of 
course, as our correspondent intimates, its successful operation pre-sup- 
poses that union and harmony which should always exist. 

The well written letter of Dr. G-arnett, contains many valuable sugges- 
tions on the subject of medical education, which we commend to the at- 
tention of our readers. We are not, however, quite so ready as he seems 
to be, to despair of effecting a reformation in the profession by means of our 
National medical organization, We are aware that the influence of the 
Schools, as they are at present represented in that body, is potent, and that 
hitherto, it has been apparently, at least, adverse to the best interests of 
the profession. But we hope for more enlightened and elevated views, and 
less selfishness on the part of our Professors, and we hope too, and expect, 
that our county medical societies will come forward in their might, to 
vindicate the true interests of medicine in the Association, by sending 
delegates to that body, who shall have a controlling influence in its delib- 
erations. 

It is unfortunate that many of our schools are so sensitive with regard 
to any influence which may tend to curtail privileges, which have in 
many instances been too long exercised as rights ; but we cannot think 
that this will always be so, or that the American Medical Association 
will not, ere long too, be the grand conservator of the true interests of 
medicine in this country. 

We are glad that our humble essay has been the means of opening 
this discussion in our columns, and we hope that it will be carried on, 
in a spirit of candor, and with a sincere desire to advance the interests of 
medicine. There is much to be said and written on the subject. 

Drs. F. G. Smith, and John B. Biddle having resigned their editorial 
connection with the Medical Examiner, Samuel Hollingsworth, M. D., 
has assumed its management, assisted by a corps of excellent writers 
as collaborators. We give Dr. H. the right hand of welcome, and 
friendship, and wish him success. 

The Stethoscope has been purchased by the Medical Society of Vir- 



118 Editorial. [March, 

ginia, and. will hereafter be edited by a Committee of that body. But 
more of this anon. We part with Dr. Gooch with regret. 



JS^ We have been obliged to omit the third article of the series on 
the American Medical Association this month. This has been occasioned 
partly by the pressure on our columns, and partly because of the time 
required to prepare a suitable portrait and biographical sketch of the late 
Nathaniel Chapman, M. D., which should accompany the next article. 
These are in course of preparation, and if not ready for the April number, 
will be issued in the form of a supplement, as soon as possible, and 
mailed to all our subscribers. 



EDITOR'S TABLE. 

A number of minor publications lie on our table this month, but we 
can afford only a very brief space to noticing a few of them. 

The " American Medical Monthly" is the title of a journal commenced 
in New York on the first of January. It is conducted by the faculty of 
the New York Medical College, E. H. Parker, M. D., being the princi- 
pal editor. Putnam & Co. are the publishers. Eighty pages — three dol- 
lars per annum. 

The " Western Journal of Medicine and Surgery" we have received 
lately, which is the first time we have ever seen that work. It has been 
changed to a monthly, and is filled with interesting matter. L. P. Lan- 
dell, M. D., Editor. 

Both the above journals are organs of medical schools. We trust 
that they will not, in upholding the interests of their schools, lose sight 
of those of the profession. 

Norton's Literary Register, for 1854. This is one of the most impor- 
tant Annuals, to literary men, published in our country, and we would 
call the attention of our readers to it. It is filled with interesting matter 
under the following heads — 1. Libraries — 2. Proceedings of Convention 
of Librarians — 3. Library statistics — 4. Educational Register — 5. List of 
American and English publications for 1853. pp. 175. C. B. Norton, 
71 Chambers street, New York. 

" The legitimate goal of professional ambition" is the title of an Ad- 
dress by William M. McPheeters, M. D., introductory to his course of lec- 
tures on Materia Medica and Therapeutics, in the Medical Department 
of St. Louis University, Oct. 31, 1853. Success is the word that solves 
the problem started by the professor, and the question, — How can that 
success be best secured, is replied to as follows — 

1. In order to succeed, the physician must be thoroughly educated, 
and with special reference to the spirit, and wants of the present age. 



1854.] 



Editorial. H9 



2. He who would cultivate medicine successfully, must have an ardent 
and abiding attachment to his profession, and so long as he lives, should 
continue to be a student. 

3. Although not absolutely indispensable, it is highly desirable, that in 
the beginning of his career, the physician should have— in addition to 
an ardent love for his profession— the stimulus of necessity— poverty. 

4. Forsaking all other pursuits, the physician must make his profes- 
sion the grand object of his life. 

5. He who would adorn his profession, and would become a blessing 
to mankind, must be an upright, conscientious and truly christian man. 

We like to see the mind of the student stored with such ideas as this 
address contains. The printers have made the author appear to great dis- 
advantage, by the bungling manner in which their work is done. 

MISCELLANY. 

We are glad to perceive that the English custom of appointing medical men to the 
office of coroner, is beginning to prevail in Massachusetts. It is surprizing that the 
common sense of communities, is not sufficient to demand such a course everywhere. 

Gov. Price in his inaugural address, recommends a geological survey of this State, 
and we are pleased to see that his recommendation is likely to be followed up by effi- 
cient action on the part of the Legislature. 

Dr. A. C. Castle, a dentist of N. Y., recently related, in the Boston Med. and Surg. 
Journal, a case in which he removed a ring from the finger of a young lady, after the 
failure of all ordinary methods, by applying quicksilver to the polished surface of the 
ring, by which means an amalgam was formed, thus rendering the gold friable. 

A bill "for the promotion of medical science," — legalizing dissections, is before the 
New York Legislature, and will, in all probability become a law, despite the puerile 
Opposition of narrow minded politicians. Shame on the men who would oppose so hu- 
mane a law ! How long is New Jersey to be behind-hand in this important reform ? 

A service of plate has been presented to Dr. Lewis A. Sayre, of New York, by the 
congregation of the 13th street Presbyterian Church in that City, as a testimonial of 
gratitude for his faithful attentions to their pastor, the Rev. Dr. Burchard, through a 
long and trying attack of illness. We cannot help believing that the res pecuni<z, or a 
good library of books, would have been much more acceptable to the doctor. With 
our utilitarian views, we regard these plate presentations as among the fashionable 
follies of the day. 

We are very happy to see that the principles embodied in what is known as the 
" Maine Liquor Law," are making steady progress throughout the country, and that 
they bid fair in a very few years to become universal. Heaven speed the day, when the 
cause of so much wretchedness and suffering — so much sickness, and so many broken 
constitutions, shall be outlawed! It is no marvel that so many physicians are found 
the firm supporters of this reformatory movement. 

Congress, some two or three years since, made an appropriation of $100,090 to the 
discoverer of the application of Anaesthetics in surgical operations : but so far, there 
seems to be as much probability of the discovery of the lost navigator Sir John Frank- 
lin, as of this fortunate individual. The bait is so tempting, that many are found ready to 
nibble at it. We believe the following list comprises all the claimants up to the present 



120 Editorial. [March, 1854.] 

time. 1. Dr. C. W. Long, of Athens, Ga., who claims to have made the discovery in 
1842, (.South. Med. and Surg. Journal, Dec. J849) — 2, the late Dr. Horace Wells, of 
Hartford, Conn., who, his friends claim, with considerable show of reason, made the 
discovery in "the latter part of the year 1844"-^3, Dr. W. T. G. Morton, of Boston — 4, Dr. 
Charles T. Jackson, of the same piace~-and 5, a Dr. Jas. Esdaile of Scotland, who pp* 
litely informs Congress that he applied mesmerism for this purpose, " as early as 1845." 
It strikes us that the claim lies between the two names first mentioned. 

John R. Stuyvesant, Esq., of New York, was recently "victimized" in the sum of 
eight to ten thousand dollars, by a quack, calling himself " John K. Seymour, M. D.," 
the wife of the quack — herself a doctress — acting as a " stool pigeon" to entrap the vic- 
tim. The plan was, to place him in such a position before the parties, as to extort 
from him a deed for real estate to the value named above, to avoid exposure on the 
charge of seduction. Proceedings were instituted against Seymour — a partial hearing 
of the case had been had, — the defendant was in jail awaiting his trial — when the 
proceedings were arrested, by the complainant being summoned to a higher tribunal 5 
the messenger being Asiatic Cholera. "Wisdom is oftentimes dearly purchased ! 

The American Journal of Science and Art, published at New Haven, long known as 
" Silliman's Journal," has recently added a feature which will make it more accepta- 
ble than ever, to medical men. It is hereafter to contain reviews and notices of ana? 
tomical and physiological works, together with abstracts from them. 



Army Medical Board.-^The Army Medical Board, which convened in the City of 
New York on the first day of December last, for the examination of Assistant Surgeons 
for promotion, and of applicants for appointment in the Medical Staff of the Army, ad- 
journed sine die on the 4th insl, 3 after a continuous session of more than two months. 

By this Board the following Assistant Surgeons, named according to rank, were ex- 
amined, and found qualified for promotion : 

Assistant Surgeons. — William J. Sloan, John F. Head, Thomas C. Madison, Israel 
Moses, Joseph K. Barnes, John F. Hammond, Levi H. Holden, Elisha'J. Bailey, Chas. 
C. Keeney, Geo. E. Cooper, Robert Murray, Glover Perin. 

The Board also examined and approved the following candidates for appointment 
in the Medical Staff of the Army. 

Robert Southgate, Virginia,- Robert L. Brodie, S. C. ; Dewitt C. Peters, N. Y. j Al- 
bert J. Myer, N. Y. ; Nathaniel .6. Crowell, S. C. ; Joseph R. Smith, N. Y. ; James T. 
Ghiselin, Md. ; Pascal A. Quinan, Md. ; John F. Randolph, Louisiana ; James C. Herri- 
don, Va. ; George Taylor, Md.$ John G. Gaenslen, Va. ; George Hammond, Md. ; 
Wtlliam J. L'Engle, Florida ; Bernard J. D. Irwin, N. Y. 



A Naval Medical Board will assemble in Philadelphia, ori the 6th Of March, for the 
examination of Assistant Surgeons for promotion, and candidates for admission into 
the medical corps of the Navy. The Board consists of Surgeons Thomas Dillard, 
Joseph Green, W. S. W. Ruschenburger, and A. A. Henderson. 



This number has been delayed a few days by the Transactions of the Medical 
Society of New Jersey. 



TRANSACTIONS 

OF THE 

NEW JERSEY MEDICAL SOCIETY. 

MINUTES OF THE 88th ANNUAL MEETING. 

The Eighty-eighth Annual Meeting was held in Temperance Hall, 
Trenton, January 24th, 1854, at 7 o'clock, P. M. 

In the absence of the President, Dr. Dayton, first Vice President, 
called the Society to order. 

A communication from the President, Dr. Lilly, was received, apolo- 
gizing for his absence, on account of special engagements at Washington 
City. 

On motion it was resolved, to have the Address of Doctor Taylor, of 
the preceeding year, read. 

By request, Dr. Butler read the same. 

The credentials of Delegates were read and accepted. 

On motion, the Report of the Standing Committee was read by Dr. S. 
L. Condict — and laid upon the table. 

Society adjourned to 9 o'clock, to morrow morning. 

ROLL OF SOCIETY. 

President, - S. Lilly. 

First Vice President, A. B. Dayton. 

Second Vice President, C. C. Blauvelt. 
Third Vice President, A. LlNN. 
Corresponding Secretary, J. Parrish. 
Recording Secretary, W. Pierson. 

Treasurer, - . J. S. English. 

Standing Committee. — J. M. Cornelison, S. L. Condict, C. Cook. 

DELEGATES. 

Essex. — A. N. Dougherty, J. H, Clark, I. A. Nichols, and J. F. Ward. 

Passaic. — J. R. Riggs. 

Morris. — J. Grimes, — Stiger, and L. Condict. 

Warren. — P. F. Hulshizer, and J. D. Dewitt, 
16 



122 TRANSACTIONS OF THE 

Sussex.— F. Smith, J. L. Allen, A. D. Morford, and T. Roe. 

Somerset. — J. W. Craig, P. D. McKissack, H. F. Vanderveer, and 
S. K. Martin. 

Hunterdon.— T. E. Hunt, J. Blane, C. Bartolette, and W. S. Combs. 

Mercer. — J. B. Coleman, J. Woolverton, G. R. Robbins, and J. Quick. 

Burlington. — I. P. Coleman, W. Bryan, A. Elwell, and I. D. Young. 

Monmouth. — R. R. Conover, A. B. Dayton, W. L. Debow, and J. S. 
English. 

Camden.— A. D. Woodruff, B. Hendry, I. S. Mulford, and T. F. 
Cullen. 

Gloucester.— B. P. Howell, F. R. Graham, J. R. Sickler, and J. F. 
Garrison. 

Cumberland. — W. Elmer, G. Tomlinson, E. Bateman, and N. R= 
Newkirk. 

FELLOWS PRESENT. 

Doctors L. Condict, F. S. Schenck, J. H. Phillips, J. W. Craig, B. 
H. Stratton, Z. Read, L. A. Smith, and S. H. Pennington. 

The following Committes were appointed. 

On Treasurer's Accounts, — Z. Read, J. Blane, and J. F. Ward. 

On Unfinished Business, — J. B. n Coleman, I. S. Mulford, and J. R. 
Sickler. 

Nominating Committee. — J. H. Phillips, Nichols, Riggs, L. Condict, 
Hulshizer, F. Smith, McKissack, Blane, Bryan, Debow, Hendry, Garri- 
son, and Elmer. 

An application from medical gentlemen of the County of Bergen, re- 
questing authority to form a District Medical Society, for that County, 
was presented, and the request granted. 

The Treasurer submitted a report, which was accepted and referred to 
the Committee on Treasurer's accounts. 

The Committee on Unfinished Business, reported the alteration of By- 
Laws, submitted at the preceeding meeting in relation to the order of 
business, which was postponed for the present. 

Also the amendment of By-Laws proposed by Doctor Ryerson, which 
amendment was discussed, amended, and adopted to read as follows — 
viz : That Chapter 7, Section 9, of By-Laws, be amended by adding the 
following proviso — viz: " Provided that a certificate of the employment 
of one year in the study of such branches of general science and learn- 
ing, as may have been designated by this Society, according to section 5 
of the Supplement to the Act incorporating the Medical Society of New 
Jersey > passed January 28, 1830, and a Diploma from &ny regularly 



NEW JERSEY MEDICAL SOCIETY. 123 

chartered Medical College, whose course of study corresponds with that 
of the Colleges now recognized by this Society, be deemed a sufficient 
certificate of study to be presented to the Censors." 

The Nominating Committee submitted their Report, which was laid on 
the table. 

Fitz Randolph's bill for advertising, was ordered to be paid, yiz : $14.00. 

The bill of $9.00 for use of the Hall, was referred to the Committee 
of Arrangements. 

Doctor L. Condict, on behalf of a Committee of the Morris District 
Society, submitted a report and resolutions, relative to Empiricism in this 
State, which was read and ordered to lie upon the table. 

A communication from Doctor W. Pierson, relating a case of triplet 
birth, was accepted. 

Doctor L. A. Smith submitted resolutions in relation to the State Lu- 
natic Asylum, for which substitutes were offered by Dr. Phillips, which 
were accepted and adopted as follows — viz : 

Resolved, That as a profession we feel deeply interested in the treatment 
of the insane, and earnestly desire that the State should furnish such ac- 
commodations, as will fully meet the wants of that unfortunate class of 
the citizens of the State. 

Resolved, That we believe the Asylum ought to be so enlarged as to 
accomplish this purpose; and that the profession should be properly 
represented in the board of managers. 

On motion, Resolved, That a Committee be appointed to prepare a 
memorial, and submit the same to the Legislature at its present session, 
in relation to the foregoing resolutions. The following were appointed 
said Committee — Doctors Smith, Parrish and Phillips. 

On recommendation of the Fellows present, Mr. Charles L. Pearson, 
of Trenton, was elected an honorary member of this Society, 

The following application was received from the District Society for 
the County of Mercer, signed by the President of said Society. 

TO THE MEDICAL SOCIETY OF NEW JERSEY. 

" The District Medical Society for the County of Mercer, makes application to the 
1 'Medical Society of New Jersey, to revoke the License granted to James McClin* 
"tock, of the City of Trenton, he having dishonored himself, by conduct unbecoming 
" a member of an honorable profession, as an agent in the publishing and vending of 
" what are usually denominated secret medicines." 
By order of the Society, 

Teenton, Jan. 17, 1854. JOHN WOOLVERTON, President. 

On motion, Resolved, That the notice given by the District Medical 
Society of Mercer to Dr. McClintock, was a legal notice of trial 



124 TRANSACTIONS OF THE 

The Committee on Treasurer's Account submitted a report, which was 
accepted. — The Committee find a balance in his hands of $258.87 — and 
recommend to the Society, not to distribute any monies to the District 
Societies the present year ; which recommendation was adopted. 

On motion, Resolved, That the Society will issue the complaint of 
Mercer District against James McClintock at 2 o'clock, P. M., and that 
notice be given to him to that effect. 

On recommendation of the Fellows present, Doctor H. A. Buttolph, of 
the New Jersey Lunatic Asylum, was elected an honorary member of the 
Society. 

The Society proceeded to the election of officers; Doctors J. H. Phillips 
and J. H. Clark were appointed tellers. 

The following were elected : — 

President, - A. B. Dayton. 

First Vice President, C. C. Blauvelt. 

Second Vice President, A. LlNN. 

Third Vice President, J. B. CoLEMAN. 

Corresponding Secretary, S. W. Butler. 

Recording Secretary, W. Pier SON. 

Treasurer, ' » J. S. English. 

Standing Committee. — =1. S. MuLFORD, Chairman, B. Hendry and 
R. M. Cooper. 

CENSORS. 

Passaic— F. S. Weller, W. Rogers, L. Burr, and R. Whitely. 

Essex. — W. Pierson, J. S. Crane, J. Q. Stearns, and J. H. Clark. 

Morris.— J. B. Munn, I. W. Canfield, N. W. Condict, andR. W. Ste- 
venson. 

Warren.— S. S. Clarke, H. Hughes, P. F. Hulshizer, R. Byington. 

Sussex.— -F. Moran, A. D. Morford, J. L. Allen, and C. V. Moore. 

Somerset. — J. W. Craig, F. S. Schenck, H. H. Vanderveer, and P. D. 
McKissack. 

Hudson. — J. M. Cornelison, C. Cook, J. Thompson, andT. R. Varick. 

Hunterdon. — W. Johnson, C. Bartolette, W. Creveling, and J. Blane. 

Mercer. — J. B. Coleman, J. A. Johnston, J. Woolverton, and Gr. R. 
Robbins. 

Burlington.— B. H. Stratton, D. B. Trimble, H. H. Longstreet, and 
I. D. Young. 

Monmouth.— A. B. Dayton, R. W. Cook, J. S. English, and W. L- 
Debow. 



NEW JERSEY MEDICAL SOCIETY. 125 

Gloucester — B. P. Howell, J. Fithian, J. F. Garrison, and J. R. 
Sickler. 

Camden.— I. S. Mulford, A. D. Woodruff, 0. H. Taylor, and C. D. 
Hendry. 

Cumberland. — W. Elmer, G. Tomlinson, E. E. Bateman, and J. W. 
Ludlam. 

Doctor Dougherty was appointed Essayist. 

Society adjourned to 2 o'clock, P. M. 

When again convened, it was on motion 

Resolved, That action on the amendment of By-Laws reported by the 
Committee on unfinished business, in relation to the time of holding An- 
nual Meetings, be postponed to the next meeting. 

Resolved, That hereafter the Committee of arrangements be instructed 
to provide dinner for the members, at the expense of the Society. 

Satisfactory information having been received that Doctor McClintock, 
owing to absence from town, had not received the notice required to be 
served upon him ; Resolved, That his trial be deferred to the next Annual 
Meeting — that the complaint be referred to the Standing Committee, and 
that the Recording Secretary give notice to Doctor McClintock. 

The irregularity in granting a Diploma noticed in the report of the 
Standing Committee, was on motion, referred to the Standing Committee, 
with the documents in relation to the same, to report at next meeting. 

The Report and Resolutions from the Morris District Society, by Dr. 
L. Condict, were also referred to the Standing Committee. 

The Preamble and Resolutions adopted by the District Society of Bur- 
lington, relating to the presentation of bills for professional services, 
were read, and, on motion of Dr. I. P. Coleman it was Resolved, That the 
Medical Society of New Jersey recommend to the several District Medi- 
cal Societies, that their members adopt the plan of presenting their ac- 
counts for medical services rendered, at the close of each case of sickness, 
or on the first of the following month. 

Doctor L. Condict, one of the delegates to the American Medical As- 
sociation, made a verbal report. 

The following gentlemen were appointed delegates to the next meet- 
ing of the Association, viz: 

Doctors L. A. Smith, J. B. Coleman, and F. S. Schenck, with power 
to supply vacancies. 

Resolved, That the next Annual Meeting be held at 7 o'clock, P. M. 

Doctor Butler, of the Sanitary Committee, made a report. 



126 TRANSACTIONS, ETC. 

On motion, Resolved, That the report be accepted and published un- 
der direction of the Committee. (See Report marked D). 

Doctor Parrish, Chairman of the First Scientific Committee, reported 
verbally, which report, with accompanying specimens, was accepted, and 
the Committee continued. Doctor Parrish resigned, and Doctor J. B. 
Coleman was appointed in his place Chairman of the Committee — all the 
other Scientific Committees were continued. 

The President, Doctor Lilly, reported that he had granted Diplomas to 
nineteen candidates, on the presentation of College Diplomas, and five 
on Censors' Certificates. 

Society adjourned. 

WILLIAM PIERSON. Rec. Sec, 



REPORT OF STANDING COMMITTEE. 



The Standing Committee of the New Jersey Medical Society for the 
year now closing, is composed of members residing in . one locality, 
and meeting daily, in the 'professional as well as common walks of 
life. This novel feature in its formation originated in the recommenda- 
tion of our immediate predecessors, in the belief, that if the Committee 
could conveniently meet often, the facilities for a full report would be 
greatly increased. It is a source of deep regret to the Committee, that 
this experiment should result so unsatisfactorily in its very commence- 
ment, and although we live in the " progressive age" when the word im- 
possible is fast becoming obsolete, the experience of the Committee 
proves that the "making of bricks without straw" is an accomplishment 
quite as difficult of attainment in this nineteenth century as it was some 
3000 years ago. 

The efficiency of the Standing Committee, and, consequently, one of 
the most important objects of the Medical Association is almost entirely 
destroyed, by the general remissness of the Reporters of the several Dis- 
trict Societies : — but four reports have been received from the entire 
State — and only one of these came to hand within the required time, thus 
leaving the duty of your Committee to be performed at the last moment, 
and from data reaching only a few localities. But it is not the desire or 
intention of the Committee to find fault with any of those who have 
come to their aid ; on the contrary, they deem the Reporters from Glou- 
cester, Sussex, Burlington and Hudson, as richly entitled to great merit 
for the minuteness of their several reports, as well as for the devotion 
which they manifest to the interests of the profession and the promotion 
of medical science — the allusion to tardiness is intended merely as a 
u verbum sat, &c." 

From the reports received, and such information as the Committee has 
been able to obtain from other sources, it appears that during the year, 
our State has been generally favored with immunity from severe diseases. 
The temperature during the winter and early spring months was not so 
low as usual, neither was it marked with so many sudden vicissitudes as 
we often experience j hence, the amount and severity of disease peculiar 
to those months was greatly diminished, 



128 TRANSACTIONS OF THE 

The past summer has been one of unusual moisture, frequent and 
heavy rains, with weeks of cloudy weather, and this often succeeded by 
southerly winds and hot sun. As the natural consequence, miasmatic 
disease in 'its various phases has been very prevalent, assuming the Inter- 
mittent type, and generally yielding readily to the ordinary treatment. 
Later in the season, Remittent and Typhoid forms of fever became quite 
prevalent in certain sections, and in Burlington County, (see Report 
marked C), "The cases assumed a more inflammatory character, with de- 
termination to the brain, followed by symptoms of continued and typhoid 
forms/' In these cases, says Dr. Grauntt, blood-letting in the first stages 
afforded the most relief — and but few deaths ensued from this form of 
fever. 

In Gloucester County, says Dr. G-arrison, (see Report marked A.) our 
fevers have assumed more of a Remittent type than is common, and with 
very little tendency to the continued form ; they readily became Intermit- 
tent, especially when aided by venesection and free mercurial purgatives. 

Dysentery appears to have prevailed to more than its ordinary extent, 
through the State generally — but not in a severe form — and in most in- 
stances assuming the "Intermittent livery." In Burlington County, 
many districts have been entirely exempt from it, while in other locali- 
ties it has appeared as endemic — but in a mild form. In the southern 
part of Medford Township (see Report marked C, 2) epidemic dysentery 
appeared early in July, and continued until the first of October. The 
number of cases was unusually large, but the fatality was very light. This 
was followed by "an abundance of Intermittent fever." 

Dr. Coleman of Burlington County, (see Report marked C, 3) says 
"towards the close of the long continued hot weather of last summer, Dys- 
entery succeeded sporadic cases of cholera-morbus and diarrhoea, in a 
form rendering it unequivocally epidemic, but proving fatal only to in- 
fants and young children." 

Scarlatina, has, it is believed, generally been of a mild type ; cases are 
reported from Gloucester, Sussex, Burlington and Hudson of this nature; 
but there have been many cases in other places, within the knowledge of 
your Committee, where it has appeared in its severest anginose form, and 
in all its terrors. Dr. Coleman mentions its epidemic appearance in 
Pemberton Township in April, in a mild form — and in the few cases of 
a higher grade which occurred, speaks highly of the " sedative effects 
of a low temperature." 

Rheumatism has been a very prevalent disease. Dr. Ryerson, of Sus- 
sex, (see Report marked B.) says it has manifested "a marked tendency 



NEW JERSEY MEDICAL SOCIETY. 129 

4o metastasis, to important organs." In Burlington district it has existed 
with highly inflammatory symptoms, and in Hudson the same remark 
applies. Active antiphlogistic treatment has, however, rarely failed of 
success. Dr. Gauntt has been using "Veratrum Viride" as an arterial 
sedative in pneumonia and other inflammatory diseases, and pronounces 
it a "valuable therapeutic agent" for controlling the circulation, and pro- 
ducing diaphoresis by its nauseating properties. He used it in the form 
of a tincture as directed by Dr. Norwood, and gave 7 to 10 drops 
gradually increasing, until nausea was produced. In a recent case of In- 
flammatory Rheumatism, after free depletion, the " veratrum sabadilla" 
was used by one of your Committee with the happiest effects, and with 
the same object in view as detailed by Dr. Gr. ; in this case the salt was 
used in doses of one-tenth of a grain every six hours gradually increased. 
The effect of Dr. Norwood's tincture in reducing the pulse is well estab- 
lished by its trial in the New York Emigrant Hospital, and it is hoped that 
during the coming year, the profession generally will give it, as well as 
the veratria a fair trial, and that our successors will be enabled to give a 
full report thereof at the next meeting of our Society. 

Pulmonary diseases have, so far as we are informed, existed in about 
their usual proportion, during the year, nothing especially interesting 
presenting itself in this field, except in the reports from Gloucester and 
Hudson. During the winter and spring, these diseases were very gene- 
rally complicated with a troublesome and painful ulceration of the mouth 
and fauces — appearing about the fourth or fifth day of the sickness, in 
isolated points of yellowish ulceration on the edges and tip of the tongue, 
on the gums, lips or tonsils, and more commonly on the fauces. Some- 
times the gums were swollen and congested, simulating very closely in- 
deed, the phenomena of mercurial ptyalism. 

Whenever this affection was idiopathic, its treatment was simple and 
effectual, but when complicated with pulmonic disease, it generally re- 
sisted all treatment, and yielded only with the other disease. The above 
statement corresponds with the experience of your Committee in Jersey 
City and its vicinity. 

Croup, in its most severe inflammatory form, has prevailed to a consi- 
derable extent in our immediate neighborhood, and in a number of in- 
stances has proved fatal, particularly, where the disease had made any 
progress, and the treatment was mild and simple. In the experience of your 
Committee the disease has yielded after free venesection, emetics of 
antim. et pot. tart., hyd. chlor. mit. and stimulating expectorants, 
but the proportion of fatal cases from this disease has created considera- 
17 



130 TRANSACTIONS OF THE 

ble alarm among our citizens, and the profession themselves have been 
anything but satisfied with any and all of the remedies which have been 
resorted to. 

The tendency to cutaneous disease, in the form of purulent tumors, 
that has attracted the attention of the Standing Committee for two years 
past, still continues, and we believe tp a greater extent than heretofore. 
Every part of our State of which the Committee haye any knowledge, is 
affected with it, and it seems to prevail very generally throughout our 
pountry, as well as Great Britain, and on the Continent. The Be- 
porter from Burlington County says, " every bruise, blow or scratch, 
however slight, is followed by a gathering, boil, carbuncle, whitlow, or 
some other disagreeable eruption, and the only remedy affording prompt 
and decided relief, was free incisions followed by warm fomentations.' ' 
The same report alludes to the existence of Erysipelas of the head and 
face, as more frequent than usual. Several cases of this disease have 
fallen under the observation of this Committee, but there was nothing 
peculiar in their character or treatment. 

Variola is evidently on the increase, both in the city and in the coun- 
try — -doubtless owing to the crowds of immigrants from the European 
shores — but this i3 not the only cause ; vaccination has for years past 
been too much neglected by our entire population, and from the frequent 
occurrence of varioloid disease, there is reason to fear that our profession 
has not been as faithful in attending to their vaccinated patients as they 
should be. Dr. Byerson, of Sussex, suggests that it should be enforced 
by penal enactments, and that it be the duty of the Assessor to enquire 
into the facts in each family, and enter the same in his returns. 

The Standing Committee would respectfully recommend this matter to 
the attention of the Society at its present meeting. 

Two cases of placenta prcevia, are given in the report from Glouces- 
ter, in both of which the placenta was expelled spontaneously, some mi- 
nutes in advance of the foetus, without the occurrence of any hemorrhage, 
and with safety to the children in both cases. 

One of these cases was that of twins, where (i the extruded mass con- 
sisted of the double placenta, from which originated the cords of both 
the unborn children." 

The same report gives an interesting account in detail, of a serious 
gun-shot wound through the knee-joint — it was made by a large board-? 
ing pistol loaded with slugs, the muzzle being within a few inches orthe 
knee. The load perforated the inner condyle, passed through the joint, 
exposing the cavity, and carrying away a portion of the inner edge of the 



NEW JERSEY MEDICAL SOCIETY. 



131 



patella. The patient beirig a young man of perfectly temperate habits 
and of general good health, amputation was wisely deferred, for the pur- 
pose of trying to preserve the limb. In addition to the other treatment 
usual in such cases, resort was had to the constant application of iced 
water and pounded ice, and With the happiest effects, as, in about 
three months, the patient was able to leave his bed, with a limb anchylo- 
sed indeed, but yet straight and promising to be useful. 

The attention of the Standing Committee has been called to a case of 
alleged irregularity in granting a Diploma to practice physic and surge- 
ry in this State. The facts in the case are not sufficiently before the 
Committee to enable them to judge fully of its merits, neither are the 
Rules and Regulations of the Society sufficiently explicit to meet all the 
points involved. The facts will therefore be stated without mentioning 
the names. A. B. received a certificate from a Board of Censors of his 
examination, but, from some cause unexplained to us, this certificate Wa3 
not presented to the President of the State Society, until about twenty 
years had elapsed, and when so presented, there was no endorsement of 
the payment of $15, as required by our existing rules. The President 
being well acquainted with the applicant, and knowing him to have been 
a highly respectable practitioner, in good standing during this period, 
and being assured too that the sum of $15 was paid at the time of re- 
ceiving the certificate, granted him the usual Diploma, with an interline- 
ation that the license take effect from the date of the certificate. 

Irregularity is charged — 1st. On the unusual interval between the 
dates of the certificate and the diploma. 2d. On the interlineation as 
covering over a palpable violation of our laWs, during the time he was 
practising physic and surgery " Without a diploma from the Medical So- 
ciety of New Jersey." 3d. That the certificate was not endorsed as re- 
quired by the latter clause of sec. vii. chap. vii. By-laws. 

In reference to the 1st charge, it may be said that our laws assign no 
limit to the validity of the certificate, after passing into the hands of the 
candidate on the contrary, sec. xi of the act of incorporation reads, 3rd 
line from top of page 11, u Which certificate, when presented to the 
President, &c." — implying at least, indefinite extension; In reply to 
the 2nd, it is stated that the applicant was not only personally well known 
to the President, but that he had been on two different occasions recog- 
nized as a regular practitioner, by the State and District Societies ; his 
name appearing in the commissions issued for organizing District Socie^ 
ties — and to the 3rd charge, it is replied, that the President was satisfied 
of the fact that the fee had been paid, and that he could not learn that 



132 



TRANSACTIONS OF THE 



any endorsement was required by the By-laws in force at the time when 
this certificate was granted. 

In the opinion of your Committee, the 2nd charge is the principal 
ground of complaint. By sec. xii, Act of Incorporation, " no peison 
shall commence the practice &c. until he shall have passed an examina- 
tion and received a diploma from the Medical Society of New Jersey." 
A certificate of examination is certainly not a diploma from the Med- 
ical Society of N. J. Neither should the casual recognition by a District 
or State Society, in making such appointments, be construed into a virtual 
endorsement of perfect regularity ; it was a valuable testimonial to his 
character and standing as a man, and as a judicious practitioner, and also 
of the belief that he was fully licensed — but a doubt on this subject 
probably never was entertained by any member of the Society, at the 
time of such appoinment. 

The Committee are unanimous and decided in their belief, that no 
wrong whatever was intended by either the President or the applicant — 
and inasmuch as they have never had any interview with any of the par- 
ties, and of course are not in possession of all the facts and reasons for 
such action, and inasmuch as some doubtful points are involved, they re- 
spectfully refer the whole matter to the Society for its final disposition. 

It will be perceived by the Society, that the experience Of the present 
year, in our reporting system, agrees with that of the past, and that each- 
successive standing Committee makes the same complaint. 

Is not some change in the system demanded ? Your Committee un- 
hesitatingly believe there is, and therefore endorse the suggestion of their 
immediate predecessors — that each Reporter be an ex-ofiicio member of 
the New Jersey State Medical Society, &c, as will be seen on reference 
to the report of 1853. 

The reports in the hands of the Committee contain many facts of inte- 
rest, and some valuable suggestions which do not appear in this report, 
owing solely to the shortness of time allowed for its preparation. 

Respectfully submitted. 

j. m. cornelisqn, 
Charles Cook, 
S. L. Condict, 

Standing Committee. 

Jersey City, January 22, 1854'.- 



NEW JERSEY MEDICAL SOCIETY, 133 

[A.] 

Report from Gloucester County. 

To the Standing Committee of the Medical Society of New Jersey. 

The diseases of this district preserve from year to year a very consid- 
erable uniformity, both in kind and general character. Having among 
us no large towns, whether seaport or manufacturing, we are not subject 
to many of the maladies which, either from a foreign source or domestic 
origin, are so constantly rife in such communities ; and our whole section 
of country being cleared and under cultivation, and the greater part of it 
well drained, we are also, excepting along the creeks and rivers, free 
from any special causes of disease other than those arising from the vari- 
ations of the seasons or unknown atmospheric agencies. So that unless 
affected by some prevailing epidemic influence, the disorders of one year 
are distinguished from those of any other only by differences of type and 
shades of peculiarity, which, although they are very important elements 
in both the prognosis and therapeutics of the practitioner, are of such a 
nature that they can be better apprehended at the bed-side than convey- 
ed in a report. We have, during the past year, had no disease prevailing 
among us in the form, or with the generality, which would entitle it to 
be called an epidemic ; even those affections which ordinarily assume that 
character, seem rather to have been confined to certain localities than dif- 
fused at large throughout the county. This was the case with an out- 
break of scarlatina, which occurred at Mullica Hill, in the early part of 
the spring, it attacked a considerable number of families in that neigh- 
borhood and caused several deaths, although in general it took on the 
milder forms, and was amenable to proper treatment ; a few eases, and but 
a few, were met with, scattered here and there in other sections of the 
district. Its contagious principle did not appear to be possessed of that ac- 
tivity and strength, which frequently belong to it, and which in many in- 
stances spread the disease with a terrible rapidity over whole communi- 
ties. 

Pulmonary complaints, in their various forms of pleurisy, bronchitis, 
and pneumonia, were presented to us in about their usual proportion 
during the winter and spring ; they were not characterized by any pecu- 
liar severity, and would have required nothing more than a merely inci- 
dental notice ; had it not been for the frequent concurrence with' them, 



134 TRANSACTIONS OF THE 

especially among children, of a species of ulceration about the mouth and 
fauces, which often formed a very troublesome and painful complication; 
it generally was complained of first about the fourth or fifth day of the 
sickness, at which time a few isolated points of yellowish ulceration 
might be seen upon the tongue, along its edges mostly, or about the tip, 
on the gums, lips or tonsils, or more commonly in the fauces ; or the 
gums looked swollen and congested, simulating very strongly, both in 
their appearance and in the fetor which they emitted, the phenomena of 
mercurial ptyalism, so much so indeed, that when first seen in the earlier 
portion of the season, this was suspected to have been the cause of the 
affection, and the medicine in consequence more than once omitted, but 
many cases were subsequently noted where it came on, when no medi- 
cine of any kind had been administered, and others where it got well du- 
ring the regular action of mercurial remedies ', and others again, though 
not so numerous as those where it was in connection with affections of 
the lungs, in which it occurred as a purely idiopathic ailment In one of 
this latter class which came under our observation, we found that a large 
ulcer had penetrated entirely through the substance of the soft palate, 
forming an elliptical shaped aperture, which, though not without diffi- 
culty, was at length healed up by the persevering application of lunar 
caustic to the edges. But in whatever manner the disease may have com- 
menced, the ulcerations soon extended over the whole interior of the 
buccal cavity, especially about the tonsils and the posterior pharyngeal 
region, adding very materially to the patient's sufferings, and making 
every attempt at deglutition So exceedingly distressing as in many instan- 
ces to interfere with, or even prevent the proper administration of medi- 
cine or food. They occasionally passed downward into the larynx and 
gave rise to a species of croupy inflammation there, which complicated 
very seriously the original pulmonic disease. It was not noticed that they 
added really to the danger of the case, or aggravated the original affec- 
tion of the lung, but they interposed such serious obstacles in certain 
persons, to the regular use of remedies, or proper diet, as may in that 
manner have tended to induce a fatal termination where it might other- 
wise have been avoided. 

The treatment which was generally employed, consisted in the free 
use of astringent and detergent gargles for the milder forms, and strong 
washes of nitrate of silver, or, preferably, sulphate of copper in solution, 
pencilled on the sores, three or four times in the day for the more severe 
cases. When occurring idiopathically, it was by these means very readily 
arrested, but when intercurrent with the diseases of the lungs, it would 



NEW JERSEY MEDICAL SOCIETY, 135 

often persist, despite all efforts at relief, until the pulmonary complaint 
began-to yield, when it would rapidly subside. I now call to mind no 
case where it outlasted the original disorder. No alteration was found 
necessary in the general treatment of the affections of the lung, from that 
which is ordinarily called for by those diseases — bleeding, mercurials, 
antimony, purgatives and blisters were used singly, or in succession or 
combination, according to the character of the case and the constitution 
of the patient, and with quite the ordinary measures of success. 

Our summer diseases, diarrhoea and dysentery , although not very ma- 
terially lessened as to number, when compared with our last reports, 
were considerably lightened in severity. The mortality was slight, and 
the patients rapidly convalesced from the attack. The habitudes of dys- 
entery are very peculiar in its disposition to affect certain limited locali- 
ties, differing however, in different years. It has occurred to us several 
times to meet with it prevailing very generally and often fatally over an 
area of a few miles in diameter or circumference, attacking almost every 
. family within that range, while but few would be disordered by it in any 
other portion of the county. In the succeeding years however, those 
parts which had at first been exempted, might one after another be sub- 
jected to it in a similar manner, although some locations seem to enjoy a 
more general immunity, and others to be more liable to the disease. It has 
not prevailed to any great extent, that we are aware of, over our county 
during the past year, beyond what is ordinarily met with as the result of 
the combined action of warm weather and imprudencies of diet. Since 
the middle of summer, those dwelling along our water courses have been 
very generally troubled with intermittent and remittent fevers, much 
more so than in some previous years. There are great differences in this 
respect from year to year, as is evidenced by a comparison of the reports 
of former seasons ; upon what these differences depend is by no means 
well established. Whatever it may be, it must be very extensive in its 
operations, as it manifests an influence over a distance of many miles, 
upon the river shore, and also inland along every stream which flows 
into the river, causing a simultaneous prevalence or decline of the disease 
in every part of these extended sections. It is however, mostly limited 
in its action to the neighborhood of the water courses, and seldom pre- 
vails to any notable extent excepting in their immediate vicinity. The 
fevers of the present year have assumed more of a remittent type than is 
generally customary to them, but there was very little of the disposition 
to run into the continued form which is sometimes so strongly marked, 
and which when present in a decided manner causes many cases to pass 



136 TRANSACTIONS OF THE 

into that tedious and dangerous state, notwithstanding all our best direct- 
ed efforts to prevent it. During the present season, on the contrary, al- 
though they commenced in the remittent form, they were more disposed 
after a few days, especially where assisted by vss., or free mercurial pur- 
gation, to become intermittent, when they were easily controlled by the 
usual remedies. Venesection was very frequently demanded to modify the 
force of certain local determinations, or to induce an intermission in the fe- 
ver, and it generally produced the very best results. In several cases, the 
period of the commencement of the paroxysm was marked, not by a chill, 
but by the occurrence of severe and long continued vomiting, which, un- 
less checked, did not cease until the paroxysm had passed through all its 
stages; it was controllable in the majority of cases by the use of a pill of 
i gr. or ii gr. of opium, and the employment of the effervescing mixture 
as a drink. 

Dr. Fithian, of Woodbury, reports two fatal cases of yellow fever in 
the neighborhood of Red Bank Ferry, both of which had been probably 
contracted in the infected district of Philadelphia. This was included 
between Lombard and Almond, and between Second street and the river, 
and was probably induced there by the cargo of the bark Mandarin, 
which was discharged at South street wharf, in the immediate vicinity of 
which was the greatest mortality and the largest number of cases. Dr. 
Howell (from whose essay before our semi-annual meeting the above 
facts are derived) has ascertained that there were in the city somewhere 
about 160 cases of this fever, of which number some 30 are reported as 
having recovered. Among the lodgers at the Hotels upon the wharves j 
there were many deaths, but only one is reported from the merchants 
who did business along the wharves ; probably, thinks Dr. H., because 
they left the region before night, at which time he considers the miasm 
to have the greatest power. The streets which furnished the most of the 
cases were those next above the river front, two or three small courts 
and alleys extending lengthwise with the river, but narrow and confined, 
of these, the nearer the river were those most diseased, and of those more 
remote, the lodgers in chambers facing the river seem to have been more 
liable to. the seizure : the treatment was various and unsettled, and as 
may be gathered from the statistics, far from satisfatory in its results. 

Dr. Sickler reports two cases oi placenta prsevia which possess consid- 
erable interest as bearing upon the question so much mooted of late, as 
to the propriety of delivering the placenta in such cases, instead of turn- 
ing the child. In both the instances referred to, the placenta was spon- 
taneously expelled some minutes in advance of the expulsion of the foetus, 



NEW JERSEY MEDICAL SOCIETY. 137 

without the occurrence of any hemorrhage after the detachment of the 
placenta, and with safety to the children upon both occasions, although 
one of them was a case of twins, in which instance the extruded mass 
consisted of the double placenta, from which originated the cords of both 
the unborn children. These cases show the feasibility of the operation 
of delivering the placenta first, under certain favorable circumstances ; 
but the advisability of the plan, and the determination of the conditions 
in which it should be practiced, must be decided by an induction from a 
larger number of cases than have yet been submitted to the professional 
public. 

A case of gunshot wound penetrating through the knee joint, 
came under our notice in the early part of summer, of which we give 
the outlines, as a contribution to that very important part of surgery, re- 
lating to injuries of great joints. The patient was a young man of per- 
fectly temperate habits, and general good health, although at the time of 
the accident he had just recovered from an attack of yellow fever, con- 
tracted in a southern port to which he had been trading, in his capacity 
as mate of a coasting vessel — the injury was caused by the discharge of 
a large boarding pistol filled with slugs, from the tube of which he was 
endeavoring to pull the cap ; the load entered the femur of the left leg 
(which was in a bent position, and within a few inches of the muzzle of 
the pistol,) near its lower extremity, and perforating the internal condyle, 
passed through the joint, opening the articular cavity, and carrying away 
at its exit, a portion of the outer edge of the patella just above the inser- 
tion of the ligaments. In view of the great mortality attendant upon 
such wounds under almost any circumstances, an amputation was propo- 
sed in a consultation which was held soon after the case came under our 
notice ; but as this was not until forty-eight hours after the injury, and 
as these had passed without any unfavorable symptoms either of excite- 
ment or depression, and in consideration of the temperate character and 
constitutional advantages of the patient, it was decided to defer it for a 
time, and to institute measures for endeavoring to preserve the limb. 
In addition to the antiphlogistic treatment required to quiet the arte- 
rial excitement, which was however, very slight, opiates and mor- 
phia were directed at such intervals, and in such quantities as were 
needed to soothe the nervous irritation. The local treatment consisted 
in the constant application over the whole joint, of cloths dipped in iced 
water, or pounded ice in substance, as recommended by MM. Guthrie 
and Baudens, the latter of whom speaks of it as having been used with 
signal success in the French army of Algeria, and during the revolution in 



138 TRANSACTIONS OP THE 

Paris in 1848. The effect of it in the present instance was to quiet all se^ 
verity of pain,, and prevent any violent manifestation of articular inflamma- 
tion throughout the whole duration of the treatment. The result of which 
was, that in about three months the patient was able to leave the bed 
with a limb, anchylosed indeed, but still straight and promising to be 
useful. The application of the ice was discontinued when suppuration 
was thoroughly established, art J all spmptoms of local inflammation had 
subsided. Very respect^ ly yours. 

J. F. GrARRISON, 

Reporter of the Gloucester District 
Swedesboro' Gloucester Co. 

Dr. J. M. Cornelison, Ch'm. &c. 



[B.] 

Report from Sussex County. 
To the Standing Committee of the Medical Society of New Jersey. 

A sufficiently comprehensive report of the diseases of so large a dis- 
trict as Sussex county cannot easily be given, owing to the difficulty of 
obtaining accurate details of its medical history. Such a report requires 
a regularly systematized method of obtaining facts. 

I shall therefore confine myself to a few desultory statements as to the 
prevailing diseases of the past year, and a few hints on other matters of 
interest coming within your province. 

The prevailing diseases of a series of years in this county are quite 
uniform, and the different years differ- principally by reason of their dif- 
ferent grades of severity. There are some epidemics which have never 
reached us. The facts in geology and in climatology, thereby indicated, 
may perhaps not always elude a diligent search. 

Our prevalent diseases are inflammatory affections of the lungs, in- 
flammatory rheumatism, measles, scarlatina, erysipelas, typhoid fever, 
and the miasmata, including dysentery. As an exception to the general 
rule above laid down, we have had for two years an endemic visitation 
of eczema impetigenoides. Here again, the astiology is very desirable. 
But the causes of endemics are perhaps too recondite for human percep- 
tion or reason. 

Diseases of the respiratory organs have prevailed, both epidemically 
and sporadically, but there has been very little pleuritis. In the north- 



NEW JERSEY MEDICAL SOCIETY. 139 

western part of the county occurred an epidemic of marked asthenic 
type, which attacked, principally, the extremes of life, and among the 
aged, was especially fatal. In these asthenic cases, I believe it is almost 
universal, that the mucous tissue everywhere is involved, and in these 
cases, mercurials often have to be resorted to very early. 

But this treatment ■ is not so necessary in the ordinary simple cases. 
And yet here, perhaps everywhere, it is adopted very often almost at the 
commencement. Antimonials do not produce their sedative effects when 
they excite intestinal irritation, and this they almost universally do, when 
given without opium, with this they are manageable even in large doses, 
in which their sedative effect is most marked. But because opium ar- 
rests the secretions, and in certain stages of diseases of the lungs, tends 
to produce coma, there is an unwillingness to prescribe it. The course 
often pursued, is to prescribe antimony singly, until it has even increas- 
ed the original disease by creating a new focus of constitutional irritation, 
and then to resort to calomel. A few drops of laudanum at the com- 
mencement, joined with the antimony, and continued pro re nata, would 
save this necessity. But the case is even worse than this, for the irrita- 
tion first excited by the uncombined antimony, is very apt to continue 
under the calomel, and render opium necessary, and that too at a stage 
of the disease when there is a real risk of coma. 

Rheumatism has been unusually prevalent, with a very marked tendency 
to metastasis to important organs. The results of practice here, confirm 
the recent opinion, that blood-letting is especially adapted to this disease. 
The metastasis to the heart does not however, require such heroic vene- 
section as is supposed and believed. I speak from experience of both 
modes. It is a question why this disease is so much more prevalent in 
the spring. It is said, I know not how truly, — that it is quite common 
among Indians. It is, with sailors and soldiers. Two years ago, after 
an epidemic of remittent fever in a certain part of the county, the con- 
valescent patients were frequently attacked (after a few weeks, and as 
is said " after gaining very rapidly" and becoming fleshy,) with this dis- 
ease. Is it not possible from the fact that Indians, sailors, and soldiers, 
at all times, and all people in the winter, eat more animal food, that it is 
a disease of excessive nutrition? I believe that chronic rheumatism is a 
disease of the chylopoietic viscera causing depraved nutrition. 

The miasmata have presented no peculiarity. Their extent and se- 
verity bore a direct ratio to the intensity of their supposed causes. I 
have classed the dysentery of the same season with them, because of the 
marked periodicity of many of the cases. It may be however, as said 



140 TRANSACTIONS OF THE 

by Dr. Bush, that it is only compelled a to wear their livery/' having 
its own specific cause. In this disease acet. plurnbi was used, by several 
practitioners, in large doses, but I have no report of its comparative effi- 
cacy 7 save from one, who speaks highly of it. 

Though the miasmatic fever, in its severe forms, differs from typhus 
and typhoid fevers in its essential nature, it is often confounded with 
both, or rather, the old idea that typhus was the disease in all cases, is 
still entertained by some. Others who know the difference between ty- 
phus and enteric fevers, confound the remittent with this last, and as a 
consequence, there are some blunders in treatment. In the miasmatic 
fevers stimulants are often given, and cathartics withheld. The typhoid 
symptoms, in each case, may perhaps have their origin in the alimentary 
viscera, producing eccentric irritation of the nervous centres, but in one 
case certainly, it arises from follicular inflammation, and in another from 
congestion of the portal system or depraved secretions, and in the third, 
(typhus) perhaps from a similar cause. 

Typhoid fever has prevailed in the past year with about an average 
mortality with former years. Turpentine, in certain stages indicated in 
"Wood's Treatise, was found very beneficial. One case of fatal hemor- 
rhage from the bowels, after incipient, decided convalescence, shows that 
the ulcerated follicles are not all healed at that time, and require care. 
The accident in this case followed a small dose of rhubarb. 

Scarlet fever has been quite mild during the current year. I have 
however seen one case, fatal from the extension of the anginose affection 
into the larynx. As soon as the secretion from the membrane became 
established, it stopped the already swollen glottis. I have in three cases 
administered belladona in the minimum doses copied by Wood from 
Braithwaite, and found it much too large. It produced delirium in each 
case. The extract was from Scheifflin, Haines and Co., N. Y., prepared 
in vacuo, and this fact adds to the evidence already existing, of the su- 
periority of their extracts. 

I have no report on erysipelas except from Dr. Linn, who speaks very 
highly in praise of iron therein. 

The eczema, to which I alluded, has been endemic in a certain district 
for about two years, sufficiently loathsome and uncomfortable, and yield- 
ing only to hepar sulphuris, to which however, it is quite amenable. 
Some of the cases resemble prurigo in its severe form, and some resem- 
ble scabies, which the people are disposed to call it, from which however 
it differs in several particulars, among others in not having its specific 
cure. 



NEW JERSEY MEDICAL SOCIETY. 141 

Sinall-pox begins to show itself with increased frequency, and the dis- 
ease has in each case within my knowledge, excepting one, been import- 
ed from New York by our own citizens. Vaccination is too much ne-^ 
glected. The legislature ought to enforce it by penal enactment, and 
make it the duty of the Assessor to mark opposite to each name in the 
Duplicate, whether every person was himself protected, and his family 
also, if he should have one. 

This concludes all that I have to report in reference to prevailing: 
diseases. 

Among the " curious cases" of the county, one is important, viz : a» 
case of menorrhagia, (the woman was not pregnant,) in which a clot 
caused concealed hemorrhage and dilatation of the uterus to the capacity 
of a five or six month's pregnancy. This fact bears on the use of the 
tampon. 

Chloroform, which has been said to be so efficacious in puerperal con- 
vulsions, has been used in one case within my knowledge in hysterical 
convulsions with marked benefit, but it seems contrary to all science to 
apply it in eclampsia. 

A case recently occurred, where a woman taken in labor with placenta 
prsevia whilst alone, walked a quarter of a mile to her neighbor's, leaving 
a blood track the whole distance. When the accoucheur (who was not 
sent for in twelve hours,) arrived, the woman was in deliquis. Owing to 
his haste, he seized one foot, the other not being readily accessible, but 
owing to its lubricity, could not deliver until he had passed a fillet 
through the os, and around the extremity. To do this, he was obliged 
to pass both hands into the vagina, and even into the os, above which 
the foot was. 

A case of presentation of the back, at the upper dorsal region, was de- 
livered recently, or rather expelled, the practitioner not arriving until 
too late for turning. The neck was elongated, the sutures opened, the 
head flattened, and the vertex lying between the thighs, and yet the 
child was fully equal in size to the average. If the denuded cuticle is a 
proof of death, and incipient putrefaction dependent on the long time 
that had elapsed since death, then this child had been long dead. But 
this is not certain or uniform, for I delivered a foetus thus situated, some 
months ago, which had been living the day before, which was proved by 
the wife's calling the husband's attention to the greatness of the motion. 

I have the details of a case in which a child lived four weeks with a 
needle in the walls of the right ventricle, manifesting meanwhile all the 
symptoms of endocarditis, including anasarca, 



142 TRANSACTIONS OP THE 

Every infraction of the law by physicians having no license, has been 
promptly dealt with. I am happy to say that no homoeopathy, hydro- 
pathy, or chrono-thermalism, finds a lodgment with us. 

As the subject of sanitary laws will be before the Society, would it 
not be well to suggest the propriety of legislation on vaccination. So too, 
there are other useful subjects to which to call the attention of the le- 
gislature, such as the alternate overflow and drainage of large tracts of 
land, the ventilation of public buildings, the construction of jails, the 
situation of cemeteries, the burial of dead carcasses, and the inspection of 
food. 

Would it not be well also, for the State Society to adopt some system 
of reporting from each individual in the county, to the District Societies, 
and from them to you; and in addition, to make the period included in 
the reports uniform. 

Such a system, by stimulating to more extensive and accurate obser- 
vations and more rational deductions, would advance the general interest 
of the profession, and elevate its members, adding to the general fund of 
knowledge and expanding the intellect. Such a system would excite an 
esprit du corps, and tend to make our profession what it professes to be, the 
first in the rank of human occupations, as exhibiting the development of 
the moral and intellectual faculties ; and enable its members, each, with 
truth to say, " opiferque per orbem dicor." 

THOMAS RYERSON. 

Rep. Sussex Co. Dist. Med. Society. 
NEWTON,Z>ec. 28, 1853. 



[C] 

Report prom Burlington County. 

To the Members of the Standing Committee of the Medical Society of 
New Jersey. 

Gentlemen : — The District Medical Society for the County of Bur- 
lington having appointed me reporter, my office renders it incumbent 
upon me to present you with such information as I possess, respecting the 
general state of health, varieties of disease, and epidemics that have pre- 
vailed during this year, in this part of the State. The winter and spring 
months of the early part of the year were not so cold as usual, nor were 
they marked by those extremes of temperature, which so often occur in 
rapid succession at that season, in this latitude- — consequently the amount 



NEW JERSEY MEDICAL SOCIETY. 143 

of sickness was less than common. The diseases most prevalent, were 
Pneumonia, Pleurisy, and Acute Rheumatism; some cases of which 
were characterized by highly inflammatory symptoms ; these were gene- 
rally treated by blood-letting, tartarized antimony, mercurial or saline 
purgatives and diaphoretics — remedies, that when timely and properly 
employed, seldom disappoint the physician's expectations. But having 
seen much reliable testimony in favor of the use of Veratrum Viride, 
(American Hellebore,) in pneumonia and other inflammatory affections, 
as an arterial sedative, and having had patients suffering with pneumo- 
nia, with whom the use both of lancet and tartar-emetics were contra- 
indicated, I was induced to use this remedy as a substitute for both, and 
found it a valuable therapeutic agent. 

W. C. Norwood, M. D., of Cokesbury, S. C, who first confidently set 
forth the virtues of this medicine, in controlling the action of the heart, 
uses a saturated tincture of the veratrum, which should be prepared from 
roots that have not been long kept. 

Considering this remedy worthy at least a fair trial, we employed it 
with caution in three severe cases of Pneumonia preceeding its use, by 
free depletion and purgation ; the effects of this medicine, however, were 
so marked, that we could not in justice attribute the improvement to any- 
thing else. Later in the season, as milder cases presented themselves, 
the powers of the Tincture of Veratrum alone were trusted to, for con- 
trolling the action of the heart and circulation. It certainly reduced the 
action of the heart, and the frequency of the pulse : it also produced dia- 
phoresis and coolness of the surface, by its nauseating properties. It 
seemed to do that for the lungs which we do for an inflamed joint, when 
we keep it at rest. This remedy, by its sedative powers spares the exer- 
cise of the lungs, and prevents aggravation of the inflammation from that 
cause. The dose of the tincture is from seven to ten drops, gradually in- 
creased, until its nauseating effects are produced. The emetic effects of 
this drug, are not so violent and prostrating as tartar emetic — and can be 
repeated every hour or two, without producing excessive vomiting or purg- 
ing. I would like the members of the profession in New Jersey to give 
it a fair trial at the bedside, before they reject it as a worthless hobby. 

Dr. Norwood regards it as a sheet anchor in typhus and typhoid fevers, 
as well as in convulsions of children, from one year old and upwards, 
when there is a high degree of febrile excitement. " In hooping cough 
it stands unrivaled and alone, as a remedy that may be relied on, when 
accompanied by high fever." In the first and second of the above men- 
tioned disorders, no opportunity has been offered to give this remedy a 



144 TRANSACTIONS OF THE 

fair trial ; but in hooping-cough it has been used with much satisfaction, 
accompanied by blisters on the nape of the neck, to allay nervous irrita- 
bility. 

During the first summer months we had many heavy rains and three 
or four weeks of cloudy weather, which served well the purpose of satu- 
rating the ground, covering the meadows and filling the ditches, by which 
we are surrounded with water , and at the same time producing a most 
luxurious growth of vegetation of every description. This damp and 
rainy weather was not followed by a northwest wind and a few cool days 
and nights, which is mostly the case after an unusual quantity of rain, 
but was immediately succeeded by southwest wind, accompanied by very 
hot suns, and the most extreme and protracted high temperature that has 
been known in this latitude for many years. By this sudden change, 
the low grounds were parched, and vegetation destroyed, giving rise to 
an abundant production of vegetable miasm; and it was not suprising 
that malarious fever was produced. The type of fever which prevailed 
as an epidemic, was of an Intermittent character : this extended to a 
greater or less extent over the whole township of Burlington. This fever 
generally yielded to the judicious administration of blue mass, saline ca- 
thartics and quinia. 

There seemed to be, however, as the season advanced-, a great disposi- 
tion with some of the cases, to assume a more inflammatory character, 
with a determination to the brain, followed by symptoms^ of continued 
and typhoid fevers. Bloodletting in the first stages, afforded the 
most relief. There were but few deaths from this fever, and not 
a single one occurred under the observation of your reporter from Inter- 
mittent Fever, which is the only epidemic by which we have been visited 
during the past year. 

Dysentery, was scarcely heard of during the summer months, neither 
was cholera infantum so prevalent as usual ; when met with, it was of a 
mild form, and was frequently accompanied or followed by the prevailing 
epidemic. Persons living on the outskirts of the town, bordering on the 
creeks and meadows, were attacked by this fever without regard to age, 
sex, or condition; children from two weeks of age, and upwards, were fre- 
quently the victims of this miasma. 

We have had the most conclusive evidence during the prevalence of this 
malarious fever, that those families living in houses situated nearest the 
creeks and meadows were more generally attacked with it, and that the 
fever and ague, seemed more firmly fastened to them, showing that their 
systems were more thoroughly impregnated with the poisonous exhala- 



NEW JERSEY MEDICAL SOCIETY. 145 

tions from the parched meadows or dry borders of the streams from 
which the water had receded, in consequence of the dry weather; the 
latter being the most fruitful source of this koino-miasmata. These pa- 
tients were, of all others, the least susceptible to the influence of medi- 
cine, and when they were cured, at least so far as to be entirely free from 
either chill or fever, a recurrence of the disease within two weeks was by 
no means rare ; while those living within sixty feet of them on the op- 
posite side of the street, were comparatively free from the effects of the poi- 
soned atmosphere, excepting those who occupied houses which were opposite 
open lots, and of course free from the protection above alluded to ; show- 
ing clearly that the progress of clouds loaded with these deleterious exha- 
lations that are frequently seen on a summer or autumn evening, hover- 
ing over meadows, within a few feet of the ground, may be held some- 
what in check, by a row of houses or a sufficiently high close board 
fence, as they seldom rise higher than twenty feet above the surface, un- 
less agitated by winds, when they are carried with too much force and 
swiftness, to trouble the neighbors on the opposite side of the street. 

There seems to be a something pervading the atmosphere of this 
vicinity, which predisposes almost every body who receives a bruise, 
blow, or scratch, however slight, to a gathering, boil, carbuncle, whitlow 
or some other disagreeable cutaneous eruption ; — hundreds of men, wo- 
men and children have been affected in this manner during the past year ; 
the only remedy that afforded decided and prompt relief in whitlow 
and gathering, was free incisions into the part; a free discharge of 
matter always followed the knife, if judiciously managed ; warm fo- 
mentations served to keep up the discharge, until the parts were restored 
to their former usefulness. Several fingers and thumbs have been sacri- 
ficed to the memory of Thomson, Hahnemann, and old ladies who sell 
plasters, u that never failed to cure a felon." Of the great number of 
sufferers, many fell into the hands of these unprincipled pretenders, but 
generally to their sorrow; for after passing weeks of sleepless nights and 
restless days, using "backening" herbs, or taking pellets to produce like 
diseases in all of the fingers, or applying something more tangible in the 
shape of cure-all salves, the patients were, in a majority of cases, obliged to 
go to a physician, and have the abscess freely opened, or perhaps, if too long 
neglected have one of the phalanges removed. Erysipelas generally con- 
fined to the integuments of the head and face, is another of the forms of 
cutaneous eruption that has been prevalent to more than usual extent. 
At the onset of this complaint, if the pulse was found hard as 
well as frequent, and there was much headache, and active delirium, 



146 TRANSACTIONS OF THE 

bloodletting afforded great relief; but where there was evidence of debil- 
ity ; a feeble as well as frequent pulse, tremor, a dry and often brown 
tongue, the carbonate of ammonia, wine, or the sulphate of quinia in 
large doses conducted it more safely to a termination. 

Dr. Trimble, of this city says, in reply to questions asked him by us, 
as reporter for this county, that the only disease that has occurred in his 
practice, during the present year, that could strictly be termed epidemic, 
has been Intermitting Fever. He had, through the summer a number 
of cases of dysentery, cholera-morbus and cholera infantum, but they did 
not prevail epidemically. Two cases of Cholera Asiatiea occurred within 
his practice in the city; hooping cough and scarlatina have also come 
within his practice, but no fatal cases of either this year. 

Dr. T., says the eases of Intermittent Fever have been more numerous 
than for five years past, and have usually assumed the quotidian, and 
double tertian type. These have been easily controlled by a prompt 
course of quinine, preceded generally by mercurial and saline purgatives. 
In a few cases the disease has assumed a typhoid character, but in none 
of those did it prove fatal. Three cases proved fatal, one an aged female, 
of rather intemperate habits, died in the third paroxysm— the other two 
were infants under twelve months of age — one died in the first, and 
the other in the second or third paroxysm. In three or four cases 
of children, the chill was accompanied by convulsions; none of 
these proved fatal, though no doubt the same cause, congestion of the 
brain, caused the death of the other two. A number of patients had a 
return of the disease, at periods varying from two weeks to three months ; 
and in several of these quinine seemed to lose its influence. In about 
fifteen cases of this character, arsenic was prescribed alone, and w 
combination with ; quinine, with a promptly beneficial effect. 

In reply to my second question,— what varieties of disease have Come 
within your notice ? — Dr. T. says, "I have had cases of Apoplexy, Arach- 
nitis, Gerebritis, one case a man of intemperate habits, in which Dement 
tia supervened for several months, and terminating in complete paralysis 
and death. Delirium Tremens, Epilepsy, Convulsions, Asthma, Bronchitis, 
Haemoptysis, (one fatal case,) Phthisis Pulmonalis, Pneumonia, Ascites, 
Colic, &c, &c. I have had but few eases the past year of an unusual 
character, most of the diseases being those met with in general practice. 
The diseases have generally been mild ; and there have been very few 
deaths, in proportion to the number who have been sick." 

Dr. Butler gives the following reply to the reporter, which is submitt- 
ed in his own writing, as part of the report. 



NEW JERSEY MEDICAL SOCIETY, 147 

To FRANKLIN Gauntt, M. D., Reporterfor Burlington County. 

Dear Sir:-— In reply to your circular, I have to say that the only 
•disease worthy of being dignified by the term "epidemic," that has visit- 
ed Burlington the past year, so far as my knowledge extends, was a mild 
form of intermittent fever, which prevailed pretty generally during the 
-fall months. It however, yielded readily to rational treatment, where 
the patient was entirely under the control of his medical adviser. But 
unfortunately, no amount of caution and advice is sufficient to induce 
that care and watchfulness, which, in many instances is necessary to pre- 
vent a recurrence. 

I venture briefly to record the outlines of a single case, which will 
serve to illustrate the difference between the active and expectant modes 
of practice in this complaint. I presume all our physicians could report 
parallel cases. 

October 14, 1853. About noon, was called to see Julia F., residing 
in Beverly. She was a robust, hearty looking girl, but had been a vic- 
tim for the period of nearly six weeks, first to an ague, primarily of the 
tertian, but latterly of the quotidian form ; and second, to the heartless 
cupidity of quacks, and nostrum venders, who shamed not to eat up her 
hard earnings without rendering her the slightest equivalent. She had 
been in the hands of a homoeopathic, who had fed her industriously on 
sugar pellets, served up with promises. But latterly, being tired of wait- 
ing for the " good time coming," when the medicine would "operate," 
she had assumed the responsibility of taking between meals, a quack 
" dead shot for the ague," which cost her a dollar a bottle. She had 
also taken quinia on her own prescription, or that of her mother, until 
it had produced its characteristic effect on the sensorium. All however, 
was to no purpose, for "she was none the bettered, but rather grew 
worse." The paroxysms recurred early every morning, and the febrile re- 
action confined her to bed till about noon of each day, she thus losing about 
half her time, besides the injury to her constitution. When I saw her, 
she had a sallow complexion, and the tongue had that peculiar sickly ap- 
pearance like aerated ice, characteristic of the complaint. There was also 
pain and fulness in the region of the liver, and constipation. Gave ten 
grains of blue mass, to be followed in three hours by a dose of castor oil 
and ten drops of laudanum. At bedtime she was to take six grains of 
quinia, and early in the morning, before the time for the paroxysm to 
come on, to take six grains more of quinia and fifteen drops of laudanum, 
and drink plentifully of tea of cayenne pepper, The next day, found 



148 TRANSACTIONS OF THE 

her at her work, having missed her ague. In about ten days saw her 
again, and found her as ruddy and fresh as if she had never been sick. 
She had lost no time from the first day that I saw her, which, from the 
fact of her being very poor, was a matter of importance to her. In con- 
sequence of exposure to cold and wet the preceding day, she had a chill 
on the fifteenth day, which however, readily yielded to treatment. 

According to my experience and observation, this section of the coun-> 
ty has been remarkably exempt from disease the past year. I have seen 
no dysentery, and besides the intermittent fever already adverted to, 
none of the phlegmasia, except a few cases of remittent fever of a 
typhoid type, 

I refer to my older brethren for " anomalous cases/' 
There is one Thomsonian, alias " eclectic," and two homoeopathic Doc- 
tors in Burlington. One of the homoeopaths being armed with a diplo- 
ma from a college whose graduates are entitled to a license from the New 
Jersey Medical Society, has naturally availed himself of the advantage, 
standing, therefore, as far as the legal honors of the Society are concerned, 
on the same platform with the most gifted and honored of our Fellows ! 
* * * * * * * 

There is no doubt that in proportion as the members of our profession 
are true to themselves and to each other, will their influence predominate 
in our community. No form of quackery can flourish where the repre- 
sentatives of legitimate medicine are united. 

I respectfully suggest, whether the influence and pretensions of quack* 
ery, may not in a measure be counteracted by the members of the profes- 
sion taking some pains to keep each other apprized of the history and 
tricks of quacks, During the few. years that I have been in the profes- 
sion, I have noticed that it is the policy of many quacks, not to stay long 
in a place. Let the profession follow up these fellows, and expose 
their tricks, and J feel sure much good would result from it. 

Very truly yours, 

S, W. Butler. 

Burlington, N. $. December 23, 1853. 

Dr. William Bryan, of Beverly, a borough on the banks of the river Del- 
aware, about three miles below the city of Burlington, makes the follow- 
ing reply to a circular addressed to him by the Reporter for this county. 

" During the last summer and fall months, we have had what may be 
safely termed an epidemic disease prevailing in this district, viz : — a 
troublesome form of remittent fever, of a low grade, tending almost inva- 



NEW JERSEY MEDICAL SOCIETY, 149 

riably to typhoid, running its course in periods varying from seven to 
thirty days, generally terminating favorably. On or about the seventh 
day of this disorder, a rash or eruption made its appearance on the surface 
of the abdomen, if no change for the better took place by this time, the 
typhoid symptoms developed themselves more distinctly. Entire loss of 
appetite during the greater part of sickness, was a striking feature. 
There was seldom any appearance of special organic lesions." 

Dr.. W. L. Martin, of Rancocas, a small village about five miles 
southwest of this place, sends the following : — " Dysentery has pre- 
vailed to a limited extent in this neighborhood, but was confined to a 
particular locality along the Rancocas creek. This disease generally 
passed through families, each member being attacked with it although in 
different degrees of severity. One or two cases that proved fatal, had 
from the first a hard wiry pulse with great pain and tenesmus, in these 
cases the disease ran its course in about six days. Boils, felons, and a 
variety of skin diseases have been very prevalent." 

He also says, " malarious disease of the intermittent type, has been 
much more common in this part of the country than it has been for sev- 
eral years past. It differed very little from the ordinary intermittent 
fever, but in many cases was accompanied or followed by profuse diar- 
rhoea, sometimes taking on a dysenteric character. 

" We have one Thomsonian Doctor in this village, who is a graduate of 
the Jefferson Medical College of Pennsylvania, and I have no doubt 
taken advantage of the existing laws of New Jersey, and obtained a 
license to practice." 

The subjoined letters are from neighboring townships, and give a 
synopsis of the diseases that have prevailed in the eastern part of this 
.county. 

Yours, &c, Franklin Gauntt, M. D. 

Reporter for Burlington County, 

Burlington City, January 19^, 1854. 



[2-] 

To Dr. Gauntt, Reporter for Burlington County. 

Medford, Dec. 1853. 
During the latter part of spring and early part of summer, we had an 
epidemic Roseola which extended, so far as I am aware, considerably 
beyond our own limits — but the southern portions of our township, 



150 TRANSACTIONS OF THE 

(Medford), seemed to be the centre of its most active operations. A\-. 
most all the children in this particular section, had the rash—and it was 
not wholly confined to them, for many adults suffered, and some under 
pretty severe attacks. 

The rash sometimes closely resembled the rash of scarlatina, and in 
others, it more nearly resembled measles, without, in any case, putting 
on the creseentic appearance, usually observed in the latter complaint. 
It usually continued from two to five days; sometimes longer, and 
occasionally terminated in partial desquamation. Some fever, and slight- 
ly inflamed fauces were present in nearly every case ; and about four- 
fifths of all affected, required no treatment, and were not confined to the 
house over a day. Yet a number did require treatment, and thereby an 
opportunity was given to see the disease in its mildest, as well as in its 
severest forms. 

The disease could scarcely be considered of much importance, were it 
not a fact of some consideration, that scarlatina occurring during one of 
these epidemics, might be mistaken for roseola. Four cases came under 
my treatment, during the prevalence of the roseola epidemic, and in the 
earlier stages of each case it was impossible for me to make a satisfactory 
diagnosis. These were of the anginose variety — rash and fever existing 
some time before the disease of the fauces made much advancement. 
One of the four, a little girl 4 years old, died on the fourteenth day, tho 
others recovered. 

That epidemic roseola and scarlatina are distinct diseases, I have every 
reason to believe — yet it must be acknowledged, that when the two exist 
in the same neighborhood at the same time, it is frequently difficult to 
make out a clear and satisfactory diagnosis. 

About the first of July, an epidemic dysentery commenced in the 
southern part of our township, and continued until about the first 
of October. I do not remember that we had had this disease, in our 
neighborhood in the form of an epidemic for eight years previous. In 
1852 it occurred in Shamong township, confining its ravages to a thinly 
settled section of less than two miles in diameter. Thirty-three persons 
were attacked with the disease, and 11 died. The disease was extremely 
active, and showed itself in one of its most virulent forms. It occurred 
in September. The deaths were principally children. Evesham town- 
ship was also in the same year visited with an epidemic dysentery, 
spreading over a large portion of its territory, but the proportion of cases 
was far less, and the deaths numbered but few. 

The epidemic of this year, (1853,) confined itself principally to the 



NEW JERSEY MEDICAL SOCIETY. 151 

southern portion of our township— but few cases happening in the town 
of Medford. The number of cases occurring in my own practice, and in 
that of the physicians occupying the same field with myself, as nearly as 
could be ascertained, is 65 ; 27 adults, 38 children — 28 males and 31 
females — 8 deaths, chiefly children. 

There was a remarkable sameness in the symptoms from the com- 
mencement of the epidemic to its close, and differed in no essential points, 
from the descriptions usually given of the disease. The. treatment of 
course varied to suit the particular case. The main remedies used were 
opium and blue mass. Bleeding was not resorted to in a single case. 
Castor oil was given at the commencement, — -though not invariably, — in 
the latter stages also, if needed to unload the upper bowels. Opium in' 
half grain pills every three hours, and one-sixth grain of blue mass 
rubbed up with camph. water, gum arabie and sugar, about as often, 
formed the body of the treatment, assisted by injections if needed — by 
ipecac in the earlier stages, and by astringents in the latter stages, as the 
symptoms seemed to indicate. Children were treated with powdered 
opium; instead of pills — dose according to the age — in other respects 
as above. 

I would remark, that I prefer opium in substance in the treatment of 
this disease; but the dose I think should not be too great, and frequent- 
ly repeated. This keeps up a steady impression, which is short of that 
prostration which necessarily attends the exhibition of large doses of this 
drug. Blue mass I prefer to calomel, as the latter is more liable to irri- 
tate the stomach and bowels, but it should be well rubbed up with gum 
arabie and sugar with some menstruum, as its action is thereby rendered 
more certain. A number of cases of cholera infantum occurred, as is 
usual with us in the summer months, Three deaths. 

Diarrhoea and cholera morbus, less than we usually have. 

During the latter part of the fall we had an abundance of Intermittent 
fever — sometimes hard to break up, but usually yielding to the grandest 
of all remedies for this malady, quinine. I usually give 5 grains at a 
dose every two and a half hours until two of three doses are taken. 

Yours most truly, A. E. Budd. 

To the Reporter of Burlington County. 

Pemberton, November 29, 1853. 
The epidemics which have occurred in this neighborhood, have been 
mild ) not exhibiting any peculiar feature attractive to the pathologist, 



152 TRANSACTIONS OF THE 

In April, the scarlet fever made its appearance in so simple a form, aa 
to render the diagnosis of the first cases doubtful. Subsequently, the 
characteristic symptoms became more positively marked, and the angi- 
nose affection quite decided, but in no instance assuming a malignant 
character. In this locality, the malignant type seldom occurs. Only 
two or three epidemics presenting some such cases having prevailed dur- 
ing the last eighteen years. 

The majority of the cases during the last epidemic, would fully have 
justified the declaration of our homoeopathic friends, that, for scarlatina 
simplex, Beladonna is a specific : for in the language of Sydenham, it can 
only prove fatal through the officiousness of the doctor. The treatment of 
course was almost negative — a mild aperient sponging with tepid water, or 
diluted alcohol to allay itching and reduce the dermal temperature, with 
solution of bi. tart, potas. for drink, seemed to fulfil all the indications. 
In two or three cases, however, in which the anginose determinations 
were more urgent, the sedative effects of a low temperature were very 
satisfactory. In one case of high inflammatory type, and rapidly increas- 
ing anginose tumefaction, with large plastic patches on the mucous sur- 
faces, coma and tetanic closure of the jaws, ice cold water applied to the 
head — cold cloths to the throat frequently renewed, and pieces of ice 
thrust into the mouth and throat, by forcibly opening the jaws, in five 
hours sensibly reduced the tumefaction, restored consciousness, and even* 
tually a resolution of the engorgement without any material ulceration. 
Gargles of hydrochloric acid not only cleansed the glands and fauces of 
mucous and plasma, but communicated such a sensation of relief, that it 
is highly probable a modification of the vital movements more consistent 
with health was effected by it. 

Towards the close of the long continued and unmitigated hot weather 
Of last summer, dysentery succeeded sporadic cases of cholera morbus 
and diarrhoea. The cases were sufficiently numerous, and all other ail- 
ments partook enough of the characteristics of dysentery to establish its 
claim to an epidemic. 

It proved fatal to a few infants and young children only. Although 
quite severe in the cases of many adults, they all recovered entirely without 
any chronic sequences. Many cases of considerable severity were managed 
domestically, in various ways, according to the genius of the family, some 
With calomel and castor oil, castor oil and laudanum, quack nostrums and 
astringent vegetable infusions. The anatomical character of the disease 
appeared to be ileo-colitis in most cases. The type of rather a typhoid ten- 
dency, although one of the most satisfactory cases treated during the season > 



NEW JERSEY MEDICAL SOCIETY. 153 

was that of a young man in whom the disease was ushered in with extreme 
violence, tenesmus, active fever, hard resisting pulse, and raging headache: 
vs. §xvi.; hyd. chlo. mit. gr. x, ol. ricini §j — pediluv, tinct. opii. fgj. and 
diaphoretic ptisan cathartic repeated next day, with tinct. opii. sufficient to 
overcome pain, and arrest peristaltic movement in the interval, caused a 
resolution of the disease in two or three days. 

In the general course of treatment, those cases appeared to do best, 
where small alterative doses of blue mass or calomel were given, but in 
no instance was ptyalism induced. 

Cupping, both dry and by scarification over the abdomen, was a valu- 
able therapeutic agent, especially when followed unremittingly by fomen- 
tations. Practising upon the hint just obtained from the very excellent 
essay of the Editor of the Eeporter, on the functions of the skin, I found 
tepid sponging and the warm bath, when feasible, of unquestionable 
utility. In one case of extreme gastro-intestinal irritability, when all 
ingesta were immediately ejected — from ice to chloroform — from gum 
arabic to brandy, in which emolients, cataplasms, and other contra-stimu- 
lants failed to give relief, immersions in the tepid bath every four or 
five hours, seemed to awaken the slumbering function of the skin, ar- 
rest centripetal determinations and save the little sufferers when appa- 
rently in articulo mortis. When the season had farther advanced, and 
the vicissitudes of temperature between the day and night were greater, 
the disease abated, and almost entirely disappeared in this district, follow- 
ed, however, by a form of continued fever, assuming a course of two, 
three, or four weeks from the inception to convalescence. The main 
features were those of follicular enteritis. Although the remissions in 
the early period of the disease were well marked, quinia, in my hands, 
did not in one single instance arrest its progress, even when given to the 
amount of fifteen grains in the remission ; such doses aggravated the 
cerebral symptoms and had to be discontinued, when the fever steadily 
pursued its course. 

Of anomalous cases I have but little to say. Early in the year an 
acephalous foetus was produced in my practice,, with entire absence of 
the spinal column through the cervical and upper dorsal portions. The 
trunk and extremities were well developed, and its movements through 
the latter months had been unusually turbulent, In the entire absence 
of cerebro-spinal nervous influence on the heart, it illustrates the possi- 
bility of the early rythmical movements of that organ, (which are estab- 
lished hefore the nerves are formed,) being sustained during the whole 
mtra-uterine period by its own inherent ganglionic system, aided per- 



154 TRANSACTIONS OF THE 

haps, by the great sympathetic, after its developement. The stimulus 
of the circulating fluid on the endocardiac surfaces, in the first place ex- 
cites contractility in the cardiac tissues by means of their proper ganglia. 
Secondly, reflexed power is derived from the great sympathetic ganglion 
with which it is subsequently brought into connexion. Respiration is 
more dependent on cerebro-spinal power, as not the least indication of 
any movement of that sort was made after expulsion. 

A case of renal calculi, not anomalous in the physical condition, but 
so much so in the signs as to lead into error in the local diagnosis, has 
occurred. It was of many years standing ; its character undoubted, ac- 
companied with great neuralgic suffering. The pain and soreness excited 
by pressure, were so constantly referred to the region of the left kidney, 
that no doubt was entertained of its being the seat of the disease ; autop- 
sy however, showed the mistake. The left organ was hypertrophed with 
some granular erosions and calculous grit in two or three of the superior 
infundibuli, but not derangement enough to account for either the length 
of time or amount of suffering. The right kidney, to which no reference 
had ever been made, was atrophied, disintegrated in structure, and the 
pelvis blocked by a calculus, filling also, two or three of the infundibuli. 
The anomoly in this case, involved no practical difficulties, but shows 
that reflexed sympathies may lead to errors in local diagnosis. 

We have no guerillas established in our field ; occasionally a son of 
lobelia, with his pepper and steam comes hissing through our orbit, like 
a comet from the far off regions, and disappears as suddenly. 

I. P. Coleman. 

[D-] 

Laws of New Jersey affecting the Life and Health of Man,* 

I. COLONIAL LAWS. 

(a) Acts passed in Sir George Carteret's time. 

1668. May 30. — An Act for the punishment of the crime of mur- 
der, p. 78. f ' 

1668. May 30. — An Act against drunkenness, p. 83. 

1668. May 30. — An Act concerning taking away a man's life. (Only 

* This compilation will be found to be very full, and may comprise the titles of 
some laws which might have been omitted. The compiler would have been glad 
to have revised the whole, but it involved more time and labor than he could spare. 
He hopes however, that the profession will find this paper, such as it is, a useful 
one for reference. 

f The figures refer to " Grants, Concessions, Acts, &c, passed before the surren- 
der to Queen Anne in 1702.'- By Aaron Learning and Jacob Spicer. Phila. (No date). 



NEW JERSEY MEDICAL SOCIETY. 155 

to be taken according to law, and at the mouth of two or three sufficient 
witnesses.) p. 84. 

1668. Nov. 3. — An Act concerning ordinaries for the entertainment 
of travelers. (Forbids any, except ordinary keepers, to retail " Drink 
of what sort soever, under the quantity of two gallons." These ordina- 
ries to be provided for by the town, and the keeper to have a license 
from the State Secretary, obliging himself to make sufficient provision 
of meat, drink, and lodging for strangers. Towns neglecting to provide 
such ordinaries, to forfeit forty shillings fine to the country, for every 
month's default. The last clause of the a item" reads as follows : "And 
no person whatsoever (as well the ordinary keeper as others,) shall re- 
taile any sort of drink as aforesaid, under the quantity of two gallons, 
under the penally of paying ten shillings fine for every such default, to 
the country.") p. 87. 

1675. Dec. 2. — An Act to record births, marriages, and deaths. 
(Pee to the clerk, three pence a name. Penalty for not reporting, one 
shilling for the first week, two for the second.) p. 100. 

1677. Oct. 10. — An Act forbidding the selling of drink in private 
houses, or elsewhere, excepting by li such person or persons as are made 
choice of to keep ordinary in each town," in quantities less than one 
gallon, p. 127. 

1677. Oct. 10. — An Act regulating the retail price of liquors, p.128. 

1681. July 23. — An Act to forbid disposing of intoxicating drinks 
to the Indians, p. 137. (Laws on the same subject were passed before.) 

(6) Acts passed under the government of the twenty-four Proprietors. 

EAST JERSEY. 

1682. March. — An Act against the crime of murder, p. 234. 
1682. March. — An Act concerning domestic animals, by whose fero- 
ciousness human life is sacrificed, p. 234. 

1682. March. — An Act punishing drunkenness, p. 242. 

1682. Nov. Dec. — An Act to prevent tippling and other disorders 
in ordinaries, by town dwellers, p. 260. 

1682. Nov. Dec. — An Act for regulating of ordinaries, p. 261. (Re- 
pealed, 1695. p. 312.) 

1686. April 6 to 19. — An Act against wearing swords, duelling, &c. 
p. 289. 

1692. Sept. Oct. — An Act prohibiting the selling of strong drink or 
liquors to the Indians. (Penalty changed from whipping to fining, in 
1693. p. 327) p. 316. 



156 TRANSACTIONS OF THE 

1692. Sept. Oct- — An Act for regulating of ordinaries, and raising 
excise upon strong liquors, p. 318. 

1693. Oct. Nov. — An Act for taking off the excise, and empowering 
the Governor to grant license to ordinary keepers, p. 332. 

1698. Feb. Mar. — An Act for the restraining and punishing of pri- 
vateers and pirates, p. 363. 

WEST JERSEY. 

1681. Nov. — An Act to protect Proprietors, Freeholders, and inhab- 
itants, in the enjoyment of life, limbs, liberty, &c, except by trial of 
jury of twelve good and lawful men. p. 428. 

1681. Nov. — An Act forbidding the sale of strong liquors to the 
Indians, p. 434-5. 

1682. May. — An Act, additional to the preceding, p. 445. 

1682. May. — An Act to prevent clandestine and unlawful marriages, 
p. 446. 

1683. May. — An Act for preventing of swearing, drunkenness, 
whoredom, and profaneness. p. 460. 

1683. Sept. — An Act for a public registry of immigrants, p. 479. 

1684. May. — An Act similar to the last. p. 495. (Grood acts !) 
1692. Nov. — An Act for suppressing selling rum, &c, to Negroes 

or Indians, p. 512. 

1694. May. — An Act discouraging whoredom and adultery, p. 527. 

(c) Acts passed after the surrender of the government to Queen 
Anne in 1702. (Queen Anne's reign began March 8, 1702.) 

1702. Queen Anne's instructions to Lord Cornbury, her first Go- 
vernor. A yearly census ordered to be taken ; also, registries of births, 
christenings, and burials, to be made. p. 634. Drunkenness andjle- 
bauchery to be discountenanced, p. 639. 

1704. Djc. 12. — An Act for suppressing of immorality, p. 3. # 
(Drunkenness, tippling, adultery, fornication, inter alia.) 

1709. April 4. — An Act for the relief of the poor. p. 8. 

1709. April 4. — An Act for regulating of Ordinaries. (Supplied 
and repealed by an act passed March 15, 1739.) p. 9. 

1717. Jan. 26. — An Act for laying an excise upon all strong liquors 
retailed within this Colony of New Jersey. (This act expired by limit- 
ation, March 1, 1722.) p. 42. 

1719. March 27. — An Act to prevent clandestine marriages, p. 53. 

* The figures refer to " Acts of the General Assembly of the Province of N.Jersey." 
By Samuel Allinson, Burlington, 1776. 



NEW JERSEY MEDICAL SOCIETY. 157 

1719. March 28.— An Act to restrain Tavernkeepers and retailers 
of strong liquors, from crediting any person more than ten shillings. 
(Supplied and repealed by an Act passed, March 15, 1739.) p. 61. 

1725. Aug. 13. — An Act regulating the packing of Provisions. 
(Supplied and repealed by an Act, March 11, 1774.) p. 71. 

1730. July 8. — An Act imposing a duty on persons convicted of 
heinous crimes ; and to prevent poor and impotent persons from being 
imported into this Province of New Jersey, &c. p. 84. 

1739. March 15. — An Act for regulating Taverns, Ordinaries, Inn- 
keepers, and retailers of strong liquors, p. 102. 

1741. Nov. 4. — An Act toj>revent the destroying and murdering 
of bastard children, p. 122. 

1748. Dec. 16. — An Act for the more effectual preventing of Lot- 
teries, playing of Cards and Dice, and other gaming for lucre of gain ; 
and to restrain the abuse of Horse racing within this Colony for the 
future, p. 187. 

1751. Oct. 23. — An Act to restrain Tavernkeepers and others from 
selling strong liquors to Servants, Negroes, and Mulatto Slaves, &c. p. 191. 

1751. Oct. 23. — An Act to prevent the exportation of unmerchantable 
Flour to foreign markets, p. 193. (This Act expired by limitation, 
March 1, 1752. For its details, see "NevilVs Acts of N. J." p. 445.) 

1758. April 15. — An Act for preventing Spirituous Liquors being 
sold to common soldiers without leave from proper authority, &c. p. 218. 

1758. Aug. 12. — An Act for the settlement and relief of the Poor. 
p. 222. (For details, see Nevill, Vol. 2. fol. pp. 217, &c.) 

1760. Dec. 5. — An Act for the preservation of the Public Records 
of the Colony of New Jersey, p. 233. 

1761. Dec. 12. — An Act effectually to prevent Horse-racing and 
Gaming in the Province of New Jersey, p. 241. 

1768. May 10. — An Act for the better regulating Constables, Ven- 
dues, and Taverns, p. 302. 

1772. Sept. 26. — An Act to regulate the practice of Physick and 
Surgery within the Colony of New Jersey, p. 376. (Limited to five 
years from its passage.) 

1772. Sept. 26. — An Act to prevent the exportation of unmerchant- 
able Flour to foreign markets, p. 378. (Limited to seven years from 
November 1, 1772.) 

1772. Sept. 26. — An Act to prevent abuses in the packing of Beef 
and Pork, and for ascertaining the size of casks and the quantity that 



158 TRANSACTIONS OF THE 

shall be put into each. p. 384. (Supplied and repealed by an Act passed 
March 11, 1774.) 

1774. March 11. — An Act for regulating Roads and Bridges, p. 386. 
(Sec. 15 imposes a penalty on employers or laborers for asking for liquor 
on the road.) 

1774. March 11. — An Act for the settlement and relief of the Poor, 
p. 403. (Contains 35 sections.) 

1774. March 11. — An Act to regulate the packing of Beef and Pork 
and to ascertain the size of casks, p. 450. (To continue seven years.) 

II. STATE LAWS. 

1776. An Act for the Preservation of the Public Records of the 
State. 25*. 

1777. March 14. — An Act to prevent the Distilling of Wheat, Rye, 
and other grain. 25. 

1777. June 6. — An Act to suspend the operations of an act entitled 
"An Act to prevent the Distilling of Wheat, Rye, and other Grain." 66. 
(This act was suspended "until the distilling of Grain shall be prevented 
by Law in the States of Delaware, Pennsylvania, and New York, and no 
longer/') 

1777. Sept. 20. — An Act was passed substituting the word State for 
Colony, in commissions, writs, and other process. 92. 

1779. May 28. — An Act to prevent idle and disorderly persons mis- 
spending their time at Public Houses, and for the suppression of other 
immoralities. 53 (?) (Repealed by an act passed Sept. 27, 1781.) 

[Acts called for by the exigencies of the times, forbidding the expor- 
tation'of provisions, or withholding- from sale the necessaries of life, are 
omitted in this catalogue.] 

1779. June 8. — An Act to amend an act, entiled "An Act for the 
settlement and relief of the Poor," passed 11 March, 1774. 67. (Who 
to support.) 

1782. Sept. 27. — An Act to repeal an act entitled "An Act to pre- 
vent idle and disorderly persons mis-spending their time at Public 
Houses, and for the suppression of other immoralities," passed May 28, 
1779. (This act revives the several parts of acts therein repealed, which 
acts were passed, Dec. 12, 1704; March 15, 1739; and May 10, 1768.) 

1782. Nov. 15.— An Act for the relief of the Poor of the North 
Ward of the City of Perth Amboy. 4. 

*The figures designate the pages in the Pamphlet Laws of the Commonwealth. 



• NEW JERSEY MEDICAL SOCIETY, 159 

1783. An Act to repeal an act, entitled "An Act to prevent the dis- 
tillation of Wheat, Rye, and other Grain," passed March 14, 1777. 8. 

1783. An Act to repeal an act, entitled "An Act for the settlement 
and relief of the Poor," passed June 8, 1779. 8. 

1783. June 19 — An Act to revive an act, entitled "An Act to regu- 
late the packing of Beef and Pork, and to ascertain the size of Casks," 
passed March 11, 1774. 74. 

1783. June 19. — An Act to revive and continue an act, entitled "An 
Act to prevent the exportation of unmerchantable flour," passed Sept. 26, 
1772. 74. 

1783. Nov. 26. — An Act to regulate the Practice of Physic and 
Surgery in this State. 7. 

1783. An Act to procure an estimate of the number of Inhabitants 
in the State of New Jersey. 71. 

1786. An Act supplementary to an aet entitled "An Act to regulate 
the Practice of Physic and Surgery in this State," passed Nov. 26 
1783. 338. 

1790. An Act to incorporate the Medical Society of N. Jersey. 590. 

1790. An Act to regulate the granting of Licenses for Taverns and 
Inns. .617. 

1790. An Act to suppress Vice and Immorality. 619. 

1790. An Act for the registry of Marriages, Births and Deaths. 661. 

1790. An Act for the punishment of Manslaughter, &c. 725. 

1795. An Act for the support of Idiots and Lunatics, and for pre- 
serving their estates. 931. 

1795. An Act concerning Marriages. 1004. 

1796. An Act for the relief and employment of the poor in the 
county of Salem. 51. 

1796. March 18.— An Act for the Punishment of Crimes. 92. 

1797. An Act to prevent the importation of convicts into this State. 
131. (Repeals act of July 8, 1730, respecting duty on convicts, and im- 
portation of the poor.) 

1797. An Act to prevent the use of spirituous liquors at vendues. 
165. (Repeals former acts.) 

1797. Feb. 13. — An Act for suppressing Lotteries. 166. (They 
are declared common nuisances.) 

1797. Feb. 24.— An Act concerning Inns and Taverns. 180. (Re- 
peals former Acts). 

1798. An Act to carry into effect the act of March 18, 1796, for the 
punishment of crimes. 280. 



160 TRANSACTIONS Or THE 

1798. An Act to suppress vice and immorality. 399. (Repeals acts of 
Dec. 12, 1704— June 12, 1790— Nov. 20, 1790, for the relief of certain 
religious societies, and all other acts within the purview of this act. Pro- 
hibits Business and Diversion on the Sabbath — cursing — swearing — 
drunkenness — exhibitions — disturbers of religious meetings. Prosecu- 
tions, &c, against offenders.) 

1799. May 27. — An Act to register Births and Deaths when requir- 
ed. 514. 

1799. An Act to punish venders of unwholesome Provisions or Li- 
quors. 517. 

1799. An Act to prevent the exportation of unmerchantable flour. 
534. (Repeals act of June 19, 1783.) 

1799. An Act regulating the packing of Beef and Pork. 534. (Re- 
peals act of June 19, 1783.) 

1799. Nov. 19. — An Act to provide for the security of the citizens 
of this State against the introduction of contagious diseases. 567. (In 
what cases the Governor shall prohibit communication with infected ves- 
sels.) 

1799. An Act to provide against contagious diseases. 654. 

1801. An Act amending an act, entitled u An Act concerning Inns 
and Taverns," passed Feb. 24, 1797. 61. (Applicants for license how 
to be recommended). 

1801. An Act supplementary to an act, entitled "An Act for the 
settlement and Relief of the Poor/' passed March 11, 1774. 107. 

1802. Sept. 2 — An Act to regulate the packing of Beef and Pork 
for exportation. 190. 

1804. March 1. — An Act supplementary to an act, entitled "An Act 
for the support of Idiots and Lunatics," passed Nov. 21, 1795. 328. 
(How cases are to be determined. Mode of proceeding, &c.) 

1807. An Act to prevent keepers of Inns and Taverns from enter- 
taining minors. 51. 

1807. An Act ratifying and confirming the proceedings of the Me- 
dical Society of New Jersey. 54. 

1812. Feb. 3. — An Act to prevent the introduction of malignant and 
other infectious diseases into the City of Perth Amboy. 19. (Regula- 
tions as to vessels arriving.) 

1814. An Act to restrain the selling of liquors, and to prevent Tip- 
pling houses. 78. 

1816. An Act supplementary to an act, entiled "An Act for the set- 
tlement and Relief of the Poor," passed March 11, 1774, 24, (Re- 



NEW JERSEY MEDICAL SOEIETY. 16 £ 

peals 17th sec. of said Act. — (What relatives to support each other.) 
1816. Feb. 15. — An Act to incorporate the Medical Society of New 
Jersey. 29. 

1818. An Act supplementary to an act, entitled "An Act to incor- 
porate the Medical Society of N. Jersey" passed Feb. 15, 1816. 95. (Re- 
peals sec. 7 of the original act.) 

1819. An Act supplementary to an act, entitled "An Act respecting 
Inns and Taverns/' passed Feb. 24, 1797. 28. (Penalty for keeping 
up sign without license). 

1820. Feb. 28. — An Act concerning Idiots and Lunatics. 91. (Re- 
peals acts of Nov. 21, 1794— March 1, 1804— and Feb. 12, 1818.) 

1820. An Act to alter and amend certain acts concerning Inns and 
Taverns. 150. 

1820. An Act supplementary to an act, entitled "An Act for the 
settlement and relief of the Poor," passed March 11, 1774. 166. 

1820. An act supplementary to an act, intitled "An Act for the re- 
lief and employment of the Poor of Salem Co." passed March 12, 1796. 
211. 

1822. An Act to regulate the packing of Herring for exportation. 14. 

1823v Dec. 2. — An Act supplementary to an act, entitled "An Act 
concerning Idiots and Lunatics," passed Feb. 28, 1820. 51. 

1828. Nov. 28. — An Act supplementary to an act, entitled "An Act 
to incorporate the Medical Society of New Jersey," passed 15 Feb. 1816. 
56. (Repeals sec. 6 of said Act).. 

1824. An Act relative to a Census of the State of N. Jersey. 202. 

1825 Nov. 24 — An Act further supplementary to an act, entitled 
"An Act to incorporate the Med. Soc. of New Jersey," passed Feb. 15, 
1816. 38. 

1828. Feb. 28.— An Act providing for the safety of Travellers. 110. 
(Regulations for steamboats, stages, &c). 

1828. March 6. — An Act supplementary to an act, entitled "An 
Act regulating Inns and Taverns," passed Feb. 24, 1797. 202. 

1829. Jan. 23.— An Act to incorporate the City of Jersey City. 
(Sec. 9). 30. 

1829. Jan. 28. — An Act supplementary to an act entitled "An Act 
to alter and amend the act entitled l An Act concerning Inns and Ta- 
verns/ " passed 1 June, 1820. 39. 

1829. Feb. 17.— An Act for the punishment of crimes. 109. (See 
Acts of March 18, 1796— suppl. May 31, 1821— suppl. Nov. 1820— 
suppl. 7 March, 1828— and suppl. of the present year> 95.) 

Am 



162 TRANSACTIONS OP THE 

1829. Feb. 17. — An act making provision for carrying into effect the 
"Act for the punishment of Crimes," passed Feb. 17, 1829. 133. 

1829. A Resolution respecting the prevalence of Intemperance. 139. 

1830. Jan. 28. — An Act to incorporate Medical Societies to regulate 
the practice of Physic and Surgery in this State. 19. (Medical Societies 
constituted bodies corporate in the different counties where they are 
formed. Repeals the several Acts incorporating the "Medical Society of 
New Jersey," and supplements of 1816, 18, 23, and 25.). 

1831. An Act relative to the Census of N. J. of 1830. 167. 
1833. Feb. 12. — An Act supplementary to an act entitled "An Act 

concerning Idiots and Lunatics," passed Feb. 28, 1820. 91. 

1833. Feb. 15. — An Act supplementary to an act entitled "An Act 
respecting Inns and Taverns," passed June 1, 1820. 105. 

1835. An Act to prevent the burning or vending of Fire-crackers. 57. 

1835. An Act to provide for a Mineralogical and Geological Survey 
of the State of New Jersey. 90. 

1835. An Act further supplementary to an act entitled "An Act for 
the relief and employment of the Poor of Salem Co.," passed March 12, 
1796. 120. 

1836. An Act regulating the re-packing of Beef and Pork for expor- 
tation. 234. (Supplementary to an act passed Sept. 2, 1802). 

1836. An Act for the relief of the Poor. 387. (Exempts certain 
articles from execution.) 

1838. An Act abolishing the punishment of death in certain cases. 
183. (Murder to be in three degrees.) 

1838. An Act further supplementary to an act entitled "An Act 
concerning Inns and Taverns," passed 24 Feb., 1797. 241. (Indict- 
ments may hereafter describe the liquor sold as ardent spirits. Repeals 
all other acts.) 

1839. An Act further supplementary to an act entitled "An Act 
concerning Inns and Taverns," passed Feb. 24, 1797. 79. 

1839. An Act supplementary to an act entitled "An Act concerning 
crimes," passed 17 Feb., 1829. 147. 

1839. A Resolution reepecting Idiots and Lunatics, and to ascertain 
their number and condition. 241. 

1840. An Act further supplementary to an act entitled "An Act 
concerning Idiots and Lunatics," passed Feb. 28, 1820. 27. 

1840. An Act further supplementary to an act entitled "An Act for 
the relief of the Poor of Salem Co." passed March 12, 1796. 63. 

1842. An Act further supplementary to an act entitled "An Act 
concerning Inns and Taverns," passed Feb. 24, 1797. 97. 



NEW JERSEY MEDICAL SOCIETY. 163 

.1842. An Act further supplementary to an act entitled "An Act re- 
specting Idiots and Lunatics," passed Feb. 28, 1820. 138. 

1842. A Resolution to appoint Commissioners to select a site for a 
State Lunatic Asylum. 183. 

1843. An Act respecting poor Idiots and Lunatics. 82. 

1844. An Act supplementary to an act entitled "An Act for sup- 
pressing Lotteries," passed Feb., 13, 1797. 179. 

1845. March 26. — An Act establishing the New Jersey State Luna- 
tic Asylum. 164. 

1846. An Act supplementary to an act entitled "An Act establish- 
ing the N. J. State Lunatic Asylum," passed March 26, 1845. 126. 

1847. An Act to provide for the organization of the State Lunatic 
Asylum. 18. 

1847. March 3. — An Act concerning Inns and Taverns. 158. (Rev. 
Stat. 577.) 

. 1847. An Act making an appropriation for furnishing and conduct^ 
ing the New Jersey State Lunatic Asylum. 167. 

1848. An Act for the Registry of Births, Marriages, and Deaths, in 
New Jersey. 155. 

1848. An Act supplementary to an Act entitled "An Act concern- 
ing Inns and Taverns," passed March 3, 1847. 183. (Repeals former acts.) 

1848. Three Acts supplementary relating to the New Jersey State 
Lunatic Asylum. 209, 213, 218. 

1849. An Act further supplementary to an Act entitled " An Act 
concerning Inns and Taverns, passed March 3, 1847. 61. 

1849. Two supplementary Acts relating to the N. Jersey State Lu- 
natic Asylum. 240, 267. 

1849. An Act further supplementary to an Act entitled "An Act 
supplementary to an Act entitled "An Act for the punishment of crimes." 
passed Feb. 17, 1829. 266 (This Act imposes a penalty of S1000 fine, 
or imprisonment for fifteen years, or both, for causing or procuring mis- 
carriage of a woman pregnant with child.) 

1850. An Act supplementary to an Act entitled "An Act to incor- 
porate Medical Societies," passed Jan. 28, 1830. 3. (Fund for the sup- 
port of Widows and Orphans authorized.) 

1850. An Act incorporating the Parkeville Hydropathic Institute. 71. 

1850. Two Acts supplementary to an Act relating to the N. Jersey 
State Lunatic Asylum. 157, 234. 

1851. March 14. — An Act supplementary to an Act entitled " An 
Act to incorporate Medical Societies, for the purpose of regulating the 



164 TRANSACTIONS, ETC. 

practice of Physic and Surgery in this State/' passed Jan. 28, 1830. 284, 
1851. March 15. — Two Acts supplementary to an Act entitled "An 
Act to authorize the establishment of the N. Jersey State Lunatic Asy- 
lum," passed March 26, 1845. 316, 321. 

1851. March 18. — An Act to limit the hours of labor, and to pre- 
vent the employment of children in factories, under ten years of age. 321. 
1851. An Act in relation to the supplying the Townships of 
Hoboken, Van Vorst, and the city of Jersey City, with pure 
and wholesome water. 389. 

1851. March 19. — An Act supplementary to an Act entitled "An 
Act relating to the registry and returns of births, marriages, and deaths 
in the State of N. Jersey/' approved March 3, 1848. 434. 

1852. Feb. 11. — An Act to authorize and empower the inhabitants 
of the City of Trenton, to construct works to supply said City with water, 
and to provide means therefor by loan. 9. 

1852. Feb. 11. — Three Acts supplementary relative to Idiots and 
Lunatics. 74, 91, 533. 

1852. March 23. — An Act to prevent the importation of paupers 
and vagrants into certain counties of this state. 277. 

1852. March 24. — An Act supplementary to an Act entitled " An 
Act for the suppression of Lotteries/' passed Feb. 13, 1797. 348. 

1853. March 3. — An Act relative to habitual drunkards. 237. 
1853. March 10. — An Act relative to the Lunatic Asylum 383. 

(Enlargement.) 

1853. March 10.— A resolution relative to a State Prison Hospital. 

488. 

SUMMARY. 

Acts relating to, Capital Crimes, 12. — Drunkenness, and other immo- 
ralities arising from intoxicating beverages, 48. — Registration of Births, 
Marriages, and Deaths, 6. — Relating to domestic animals by whose fero- 
ciousness life is endangered, 1. — Carrying offensive weapons, duelling, 
&c. 1 — Piracy, &c, 1. — Marriages,. 3.- — Registry of immigrants, 2. — So- 
cial vices, 8. — Census, 4. — The relief of the Poor, 14. — Packing and ex- 
portation of provisions, 12. Against importing poor, and impotent per- 
sons, and convicts, 3. — Lotteries, horse-racing, Gaming, &c, 5. — To pre- 
serve Public Records, 2. — To regulate the Practice of Physic and Surgery, 
12. — In relation to to distilling wheat, and other grain, 2. — Idiots, Lu- 
natics, and Lunatic Asylum, 25. — Unwholesome provisions, 1. — Conta- 
gious diseases, 3. — Safety of Travellers, 1. — Sanitary measures in cities, 
3. — Mineralogical, and Geological Survey, 1. — Firecrackers, 1. — Hydro- 
pathic Institute, 1. — To limit the hours of labor, and prevent the em- 
ployment of children in factories under ten years of age, 1. — State Prison. 
Hospital> 1,— Total, 174. 



THE 

NEW JERSEY MEDICAL REPORTER. 

VOL. VII. APRIL, 1854. NO.IV. 

The Speculum and its modifications — its importance in the treatment of 
Diseases of Females, with some cases illustrative. A Lecture delivered 
at the N. Y. Preparatory School of Medicine, by Augustus K, Gard- 
ner, M. B., Instructor in Obstetrics and Diseases of Females — one of 
the Committee on Obstetrics, &c., N. Y. Academy of Medicine, &c, &c. 

Within the last few years, a very great change has taken place in the 
treatment of the diseases of females. Even the nomenclature has been 
changed, and terms that were once indicative of diseases, are now consi- 
dered as designating symptoms only. In the same manner that the tel- 
escope analyzes the milky way, the speculum has made clear to us what 
was. once hazily considered to be a disease denominated Leucorrhoea. 
The scalpel of the dissector evinces that Dropsy is not a disease, but the 
symptom — often the fatal one — of other grave, frequently remote, orga- 
nic changes in the system. Dropsy is no longer known among the edu- 
cated as a disease. Leucorrhoea now shares the same fate \ it is but a 
generally trivial and unimportant symptom of other serious trouble, 

The speculum uteri has been found among the ruins of Herculaneum, 
where it was buried A. D., 79, and where, till recently, it remained, 
without any account of it left in any manuscript, to lead us to suspect 
its use, unless we except Morgagni's doubtful allusion to it. It was, 
however, re-invented in 1816, by Kecamier, (deceased in 1852,) and its 
introduction into practice has shed a flood of light upon the diseases of 
females. Formerly, I saw it much employed in Paris, not unfrequent- 
ly upon eighty women a day, and although it was then used very indis- 
criminately, and, as experience has subsequently shown, often very un- 
necessarily and sometimes injuriously, I was firmly convinced of its util- 
ity in many cases. On my return to this country, I brought with me 
this instrument, and have never ceased using it in dispensary and private 
practice, with marked utility to myself in the diagnosis of diseases, an<J 

of unquestionable benefit to numerous patients in their treatment. 

22 



166 Original Communications. [Apkil, 

Since that period, this instrument has come into general use, and I 
may add, into frequent abuse. 

But there are still many who deny its utility, — not in cases of syphilis 
or cancer, where tumors exist, &c— cases where generally it is either 
useless or impossible to be adyantageously employed — but in cases of 
continued leucorrhoea, menorrhagia, abortion, &c. Now, I propose in 
this lecture, to give my opinion upon the character of cases in which this 
instrument is applicable, and, as I may chance to remember, will illus- 
trate my remarks by cases from my own experience. 

There are several varieties of persons who oppose the use of this instru- 
ment. 1. Those who cannot see — and we will not endeavor to convince 
them of its utility. 

It is impossible to view the os uteri with the speculum in one hand, 
and an eye-glass in the other. So it is also equally impossible, with an 
ultra-squeamish patient, whose last thought is to accommodate herself to 
the necessary requirements of the medical attendant. 

2. Another class is found in those whose early essays in introducing the 
speculum, did not result in bringing the os into view. They saw nothing, 
and think no one sees anything. Not unfrequently where the amount of the 
disease is greatest, there is most difficulty in "finding the os." Notwith- 
standing the familiarity acquired by constant practice, I am not unfre- 
quently compelled, rather than continue too long a sometimes painful ma- 
nipulation, to arrest the examination without getting the hypertrophied 
or retroverted os into the field of vision. Indeed it is a matter requiring 
far more tact and experience than is generally supposed, or than one 
would imagine was required. 

Not a little of the facility of making an examination depends upon the 
instrument which is employed. The varieties of these are very numerous. 
That in commonest use — the glass, lamp-chimney species — is almost va- 
lueless. It is unpleasant to introduce, being very painful in the commence- 
ment of its introduction. This objection is trivial with prostitutes and 
multipara. When it arrives at the end of the vagina it often passes an- 
terior or posterior to the cervix ; but if it displays the womb, if there be any 
deviation from its normal position, not the os but the cervix only, is vis- 
ble, and often no means will bring the os into view. Should the os be 
made visible, often the orifice of the speculum is not sufficiently large to 
admit a view of one half of the indurated and hypertrophied organ. 

The quicksilver lined instruments are open to the same objections, but 
as they concentrate the light strongly upon the exposed part, they are in 
some slight cases, of utility. 

The old fashioned three valve metallic speculi are an improvement 



1854.] Gardner — Use of the Speculum. 187 

upon the former instruments, but they have the same disadvantage of 
distending the external, rigid parts to an equal extent with those inte- 
terior ; which not only limits their use, but also is not unfrequently unne- 
cessarily painful. 

The speculum of Ricord, with two blades, which opens widely interi- 
orly, while the size of that portion within the external genitals does not en- 
large, but rather diminishes, as the instrument is opened — is the greatest 
improvement it has yet received. The only fault in this is, that 
when distended, the lax walls of a flaccid vagina will fall together within 
the blades, and obscure the vision. To remedy this defect, Charriere, 
the ingenious Parisian cutler, has added a superior and posterior blade. 
And this four bladed speculum is without question, the only speculum 
ever needed, applicable to every case, and of immense importance in 
treating these diseases. It has the advantage of being of easy entrance 
-—it greatly dilates the posterior portion of the vagina, permit- 
ing the os uteri to fall within the blades almost of its own accord ; it 
also draws aside the lips of the os uteri, permitting a limited view of the 
cavity of the os itself. 

The blades of this instrument are generally composed of German sil- 
ver, sometimes silvered, or gilded. When gilded they are not subject to 
rust or corrosion, but the altered hue, which by reflection is given to the 
parts, renders this form objectionable. When silvered, they are less lia- 
ble to corrosion from the effects of acids, and the reflection is increased ; 
but they are somewhat more costly, and the silver coating is not of per- 
manent duration. It is highly desirable that some convenient method 
be found for removing the dark stains which soon much injure the utili- 
ty of the instrument. 

Beside these instruments, ivory cones, of formidable dimensions, are 
used, where the actual cautery is applied, on account of their non-conduct- 
ing qualities. Herteloup's speculum, intended to allow the sides of the 
vagina to be seen and operated upon if necessary, is not any more con- 
venient than the four bladed instrument already mentioned. The wire 
speculum composed of firm strait wires, radiating from a centre, 
is no improvement upon this instrument. There are various modifica- 
tions, other than those I have mentioned, but they are of little impor- 
tance. The instrument is, however, constructed of various sizes to suit 
the different ages and conditions of life— those for use where the actual 
cautery is applied, are large and only applicable in the large vaginas of 
child-bearing women ; while those used for virgins, who occasionally at 
advanced age, or still rarer in youth, require this method of explo- 



168 Original Communications. [ApriId, 

Nation and treatment, are small and delicate in their construction. 

In some cases, instead of the speculum, spatulas — much resembling the 
tongue spatulas — are used to draw down the perineum, and thus to ex- 
pose an enlarged or prolapsed organ. 

Now the cases in which this instrument is of use, are quite numerous. 
In recto or vesico vaginal fistulas the speculum may be of service, al- 
though in general the spatulas are the more serviceable instruments in 
the hand of an assistant. In a very rare case of vesico uterine fistula, 
which I lately saw in the practice of my friend and coadjutor, Dr. H. W. 
Brown,-— where the urine flowed through a fistulous opening into the 
uterus, and thence made its exit through the uterus into the vagina, — the 
fistulous opening could only be discovered by drawing aside the labia, by 
means of spatulas, and pulling down the uterus into sight, according to 
the plan recommended and practised by Jobert of Paris. 

Dr. J. Marion Sims, now of New York, and late of Alabama, one of 
the most distinguished of American Surgeons, has recently shown me a 
new spatula — if it can have that name — of his own invention, which was 
invented from necessity, (ex necessitate rei) to supply a want in his own 
unique operation for the radical cure of vesico vaginal fistula. It might 
perhaps be called a levator perinei, for in his operation, the patient being 
placed upon her hands and knees, the perineum is raised up by this in- 
strument, in the hands of an assistant. 

Beside this instrument, Dr. Sims was kind enough to show me a 
model for a speculum upon a new plan, possessing some peculiarities of 
marked Utility. In its present unperfected state, I am not justified in 
making, perhaps, even this casual allusion to it. I do it however, par- 
tially, for the opportunity of incidentally giving my testimony to the 
very elevated opinion I entertain of the man, and the entire success of 
his operation in one case which I have been permitted to examine. 

In prolapsus uteri, the speculum is of service — first, in diagnosticating 
whether this descent is due to a hypertrophied os which by its weight may 
have dragged down the uterus : if so, then it is useful in subsequent treat- 
ment. If it is owing to relaxation of the vaginal tissues, then by pinch- 
ing up the vagina as it falls in folds through the blades of the instru- 
ment with a " serre-fine," as in cases reported by Marjolin, a cure may 
be effected by the adhesive inflammation caused thereby, and the conse- 
quent contraction of the capacity of the vagina. 

In syphilitic ulcers Upon the os, or in the vagina, the use of the spe- 
culum will be admitted, without controversy at the present day. 

In cases of polypi, diagnosticated by the finger, the speculum will fre- 



1854.] Gardner — Use of the Speculum. 169 

quently be of service, although not absolutely necessary, to assist in their 

removal. 

In cases of obstinate and continued leucorrhoea, dysmenorrhea, mo- 
norrhagia, and repeated abortion, the importance and value of this in- 
strument cannot well be exaggerated. 

Bennet on the Uterus — the most available and reliable book upon this 
subject, is in the hands of every one, and has been of inestimable value in 
the diagnosis and prophylaxis of these diseases. It has gone over the whole 
ground so thoroughly, that I shall not now do more than relate in this 
place, a few, from very many corroborative cases from my own personal 
experience. 

Mrs. S- , a lady residing in New Jersey, consulted me in April 

1853. She was of delicate frame, about 24 years of age, and of a re- 
markably healthy family. Her youth was one of health, till at the close 
of her seventeenth year she began to be affected slightly with dysmenor- 
rhoea. This continued with more or less severity for several years, till 
in her 23d year she was married. She had one child, but for several 
subsequent years she was much troubled with dysmenorrhea. An ag- 
gravated dyspepsia however, prostrated her strength, and very much de- 
stroyed the pleasures of life. 

. When I was called, it was with the purpose of engaging me to attend 
her in an approaching confinement which she said would take place in 
the course of two months. She attributed her increased indigestion to 
this cause, which had recently become so aggravated as to compel her to 
live solely upon stale bread of three days age, salt cod-fish, and cold 
water. This had been her diet for the three weeks antecedent to my 
visit. She was astonished that she did not grow any faster, for she 
could wear all her dresses as usual : moreover her menses appeared regu- 
larly every month, accompanied by great pain and hysteria. The total 
amount of the discharge would not spot a cloth to the size of the palm 
of the hand. I suggested the idea that she was not pregnant, but it 
was instantly negatived by the positive statement that she had felt life, and 
that her husband and mother had both seen the movements in the abdo- 
men. I said that by laying a cold hand upon the abdomen, these move- 
ments might easily be excited, and she laid down that I might feel my- 
self, the foetal movement. The uterus was not even discernible, far 
less any impulse from its supposed contents. It required much argu- 
ment and positive statement, to convince them that she was not with 
child, but that she was laboring under some uterine affection and sym- 
pathetic irritation. A speculum examination revealed a hypertrophied 



170 Original Communications. [April, 

and raspberry colored os, denuded of its epithelium, but without the 
least leucorrhoeal discharge, or any of the ordinary symptoms of that de- 
scription. Five or sis pencillings with the solid nitras argenti entirely 
removed this condition-^the appetite, strength and vigor were restored ; 
the dysmenorrhoea entirely abated, so that as she expressed herself, she 
u had never had them so unnoticeably since she was seventeen." In the 
September following she actually did become pregnant, and till the pre- 
sent time has had no bad symptoms. 

Mrs. W came to my class at the Northern Dispensary, some 

year or so after her first confinement at the full time. She complained 
of great debility and lassitude, weakness in the back, accompanied by a 
dragging sensation in the loins, a very profuse leucorrhoea, and great 
pain in urinating. On examination, the os uteri was so much hyper- 
trophied that it was too large to enter into the opening of the four-bladed 
speculum, extended to its utmost limits. The os was divided into three 
lobes, the largest posterior — evidently lacerations occurring during her 
recent childbirth — all denuded of epithelium, granulated, and bathed in 
a profuse muco-purulent discharge. The cavity of the os was visible for 
half an inch or more, and from it issued the limpid, tenacious albumen 
secreted from the glands of the cavity. In the course of a few weeks 
she was very much relieved by the ordinary local and tonic treatment, 
and she did not return again, although entirely well. 

Mrs. M , a stout, plethoric woman, with every sign of health, had 

during the year 1853, no less than three abortions at about the third 
month, without any known cause. She had no pain in the back, no 
leucorrhoea. Knowing no cause, I said that I was certain she had a local 
trouble. Examination showed a congested cervix, the cavity somewhat 
fissured, undoubtedly the cause of the abortions. The rationale is as 
follows : The gestation went on till the growth of the foetus and the con- 
sequent enlargement of the womb, gradually shortened the neck until it 
encroached upon the fissured portion. As this was done, slight hemor- 
rhage commenced, which gradually increased until the life of the ovum 
was destroyed, and it was then thrown off. 

Mrs* W , in stepping from her carriage, had a slight jar. She was 

daily expecting confinement. She went into the house feeling a slight, 
uncomfortable sensation in the small of the back. That night she was 
taken in labor, and the next morning was delivered of a large dead child, 
strangulated by the cord around its neck being tightly drawn by the 
trip in stepping upon the side-walk. She got up with no bad symptom, 
and continued perfectly well. Some year or so after, she had an abor- 



1854.] Hunton — Indigenous Medical Plants. 171 

tion at the third month, without any known cause, and but a year sub- 
sequently, when pregnant about the same time, she noticed a very slight 
discharge of bloody mucus — six months after, this was repeated — means 
were used to arrest it, and a speculum examination was proposed, and 
assented to for the next day, with the intention of cauterizing the ulcera- 
tions or fissures which were diagnosticated to be present, and the cause 
of all the difficulty. By day -light a most alarming hemorrhage com- 
menced, followed by abortion seriously threatening the lady's life. A 
subsequent speculum examination showed fissures, a hardened and gran- 
ular os, and an extremely vascular and congested condition of the whole 
vagina. In appearance, this lady was remarkable for her healthful beau- 
ty, and was never troubled by leucorrhoea or any unpleasant symptom 
indicating this serious difficulty. 

Mrs. P — '■ — , a burly Irishwoman nearly six feet in height, over sixty 
years of age, whose menses had ceased for many years, complained of 
great weakness in the back, bearing down, accompanied by leucorrhoea, 
though not excessive. On inspection, an ulceration of the size of a shil- 
ling was discovered, encircling the os. By two cauterizations the ulcer 
was healed, and the unpleasant symptoms which had defied all treatment 
for many years, were removed. 

To these few cases, scores similar could easily be added. What do we 
deduce from them ? First, that fluor-albus is but a symptom of a local 
disease. Secondly, that this same disease may be present with many 
serious affections, but still unaccompanied by any vaginal discharge. 
Thirdly, that it may simulate pregnancy. Fourthly, dysuria is caused 
by it. Fifthly, it is the prime cause by nervous agencies, of dyspepsia. 

At some future time, I will in more detail, give you further particu- 
lars respecting the protein symptoms of disease, all depending upon dis- 
ease of the os uteri, and all curable by means of the speculum. 

153 Wooster Street, N. Y., February, 1854. 



Observations on the medical virtues of some of the most prominent 
Indigenous Vegetables grown in Vermont. 

NUMBER II. 

By Ariel Hunton, M. D. 

We have growing on our hills and vales, medical plants in great abun- 
dance, superior to many imported drugs, and potent enough to cure all 
the diseases of any locality, if applied judiciously, and in season. We 



172 Ohiginal Communications. [April, 

should investigate their virtues, and record the facts we learn, for the 
benefit of others, that we may make the world wiser for our living in it. 

In this number I shall treat of astringents and bitters, both of which 
I consider tonics ; giving tone, vigor, and strength to the debilitated sys- 
tem ) bitter vegetables, an internal remedy — astringents, both internal and 
external. 

In this region, (situated 44° 37" north latitude, and 4° 26" east lon- 
gitude from Washington,) there are such a variety pf astringents, that I 
shall describe only those in common use. They are employed in the form 
of injections, — peranum, in dysentery, diarrhoea, tenesmus, griping, &c, 
usually with the addition of laudanum ; — per vaginam, in leucorrhoea, and 
other diseases of the genital organs, with the addition -of mineral astrin- 
gents, laudanum, creasote, &c. They are mostly used in decoction, as 
boiling does not injure the virtues of this class of medicines, and they 
are usually difficult to pulverize. 

The external use of our astringents in laxity, and debility of the cu- 
taneous pores, attended with profuse sweating, prolapsus of the rectum, 
vagina, &c, by washing or spunging the body, is a judicious and a cogent 
remedy, and will not interfere with any internal remedy prescribed. A 
portion of alum is a judicious addition to the wash, when applied to the 
vagina or rectum. 

In a case of convalescence from typhus fever, or any severe debilitat- 
ing illness, with extreme muscular laxity, if one of the limbs be washed 
with an astringent lotion, say morning, noon, and night, on examination 
the next morning, the one washed will feel firm and be stronger, while 
the other is flabby and soft, the particles of flesh not being in contact. 
The application acts like a bandage. Make a strong decoction of oak, 
willow, hemlock bark, or any of our numerous astringents, sponge the 
whole body, it will invigorate and strengthen. Peruvian bark is used 
for the same purpose, but why send to Peru, when our indigenous vege- 
tables are often far more powerful ? 

Quercus Alba, — White oak. This article is much used in all cases 
where an astringent is demanded. It contains more tanin than Peruvian 
bark, which renders it preferable as an astringent, which is the tonic ef- 
fect. We should lay aside our prejudices, and not use an article because 
such a professor recommends, or uses it, — but think, reason, and test for 
ourselves ; we shall discover better medical articles in the spontaneous 
growth of our own soil than many imported. The internal use of the 
oak bark, with the addition of the bark of the Cornus Florida, or Papulus, 
is a cogent remedy in all cases of laxity and debility, where a febrile ac- 



1854.] Hunton — Indigenous Medical Plants. 173 

tion is not present, united with a bitter, it is better tolerated by the sto- 
mach, and more invigorating to the system. 

Many have used this preparation in intermittent fever, and pronounced 
it equal, and some superior to Peruvian bark. 

Salix, — Willow. Of this article, we have among us several species 
belonging to the Dioecius Class. The willow is a good astringent ; is in 
its virtues nearly allied to' the Quercus, and is prescribed in the same 
complaints, and being more abundant in this section, is more used. 

Smoking the bark of the willow, and passing the smoke through the 
nostrils, will often cure a recent catarrh, and will relieve one of long 
continuance. Take the young shoots of last year's growth, scrape the 
bark from, the twigs with the edge of a knife, and burn it in a pipe. Sa- 
lix is a useful article in debility and laxity of the system, externally, 
as a wash ; internally, combined with the bark of the poplar, as with 
the oak, it agrees better with the stomach, and requires the same pre- 
caution where there is any febrile action. 

CornilS Sericea. — Blue-berried Dogwood. This article is astringent, with 
some bitterness, and is much used as a tonic in debility and profluvia, 
invigorating the body as promptly and permanently as the Peruvian 
bark. It is used with advantage in dysenteries, and diarrhoeas. A de- 
coction of the green bark is much used by Farriers, to reduce imflamma- 
tion following injuries of domesticated animals. I have seen good re- 
sult from fomenting phlegmonous inflammation in the human species ; 
indeed many of the inhabitants in this region, if they have inflammation 
following an injury have recourse to this article, and save the physician's 
fees. The tonic virtues of the above article are improved by combining 
the bark of the Gornus Florida, which contains a pure bitter, and some 
astringency. This combination is one of our best vegetable tonics, and 
may be used in all cases where such medicine is demanded. 

Liriodendroil Tlllipifera. — Common Poplar. The staminate and pisti- 
late flowers of this article occupy separate trees ; the bark of the pop- 
lar is one of our best tonics. The bark of the root, is by some, thought 
preferable; it is certain that it is easier to pulverize. Combine with this 
article some of the astringents I have described, and this is also more 
efficacious, and is a fair substitute for Peruvian bark. 

Poplar bark appears to allay nervous and hysterical symptoms, whe- 
ther by its pure tonic effect, or some other specific virtue, I am not able 
to aver. 

The barks I have described are hard to pulverize, and ought to be 
ground in a mill, or their virtues chemically extracted. They are easily 



174 Original Communications. [April,. 

obtained, and should be in universal use, and exclude many foreign and 
costly drugs, which would to me be doubly desirable. 

Primus Virginiana and P. Canadensis.— Black and Red Cherry. The- 

peach, and most of our stone fruit, contain the same essential ingredient 
as the cherry stones. The bark and berries of the two articles named r 
contain very useful medical properties, a tonic and a sedative. 

The wild or red cherry, contains the hydrocyanic acid in an eminent 
degree, and equally as much of the bitter principle, the meats of the 
stones contain the most of this ingredient. The dry berries bruised and 
the stones crushed should be put in a tight vessel, warm water poured 
on them, cork the vessel, and let it stand several days, filter, and you 
have a powerful sedative, and one that will diminish the pulse and calm 
irritation in an eminent degree, which is a point gained at least in all 
chronic diseases. 

When the bark is used, the green is preferable; it should be macera- 
ted in cold water, with the vessel covered. If dry bark is used, it should 
be pulverized, and put in a bottle and warm water poured on it, and if it 
is to be kept a long time, add a little alcohol, the less the better, it be- 
ing an article I taste not, and handle as little as possible. 

Chimaphilla UmMlata. — Pipsissewa. This article is a bitter astrin- 
gent tonic, and may be used where such an article is required. I use it 
mostly in debility of the urinary organs, to add tone to the parts, that 
the patient may retain the urine. The addition of sulphate of zinc to 
the decoction, will enhance its value. By some writers it is called a di- 
uretic, increasing the flow of urine. I cannot say it is improper to call 
any article that has any effect on the kidneys a diuretic, but I cannot 
conceive that astringents will increase the quantity of urine. I admin- 
ister them for the very opposite purpose. 

Rut)US StrigOSUS. — Raspberry, (the leaves.) The leaves of this shrub 
are in frequent use as an astringent in all fluxes, purulent ophthalmia, 
weak eyes, the thrush in children, all the species of cynanche, and as in- 
jections per rectum and vaginam. When used as a wash or gargle for the 
throat, the berries of the Rhus are added with honey, and frequently 
also alum. 

Enpatorium Perfoliatum.— Thoroughwort. This article is in more genr 
eral use in domestic practice, than any other herb among us ; having in 
a degree, emetic, cathartic, tonic, and alterative qualities. 

In the administration of any emetic, I require some warm herb tea, 
and this article being always at hand, I use it more frequently than other 
kerbs. By inducing a sensible perspiration before the operation of an 



1854.] American Medical Association. 175 

emetic, it does not cramp the patient ; the more warm fluid in the sto- 
mach, the more kind the operation. 

HlimulllS LupulHS.— Sops. The hop is a dioecious plant, and is one of 
our most useful remedies. It is a tonic, stomachic, and anti-dyspeptic, 
of the first order. The narcotic effect so much dwelt upon, I have found 
to be very slight, as I have drank a gill at a time, hundreds of times. I 
was affected with that popular and distressing disease nearly twenty years, 
tried a variety of remedies, even to kneading the abdomen, was very ca* 
pricious in my diet, ate dry crusts of brown bread, and parched corn to 
absorb the strong acid which when eructated would burn my throat, and 
I thought it as sour as the strongest vinegar I ever tasted. I also eruc- 
tated gas at times, incessantly. Conversing with a friend on the effect of 
hops in beer, that it prevented the beer from undergoing the third, or pu- 
trefactive fermentation, the thought came into my mind, why will not 
hops be of use to me. I immediately commenced taking a strong decoction 
of hops, and took no other medicine, except soda occasionally as a present 
relief; I could eat no fruit, did not eat an apple for fourteen years, I am 
now well, can eat fruit, or any food with impunity. Ought I not to have 
an exalted opinion of the hop ? 

CMonc Glabra. — Fish-blow, Snake-head. This is an excellent tonic, 
pure bitter, will often create an appetite when other bitters fail. I usu- 
ally employ it in the form of decoction, though a spirituous tincture is 
used by those who love the "critter." A carminative combined with this 
article is very proper, as with all other bitters. 

Hyde^ARK, Vt., February 25, 1854. 



AMERICAN MEDICAL ASSOCIATION. 

History of the American Medical Association. 

NUMBER III, 

BY ONE OF ITS MEMBERS. 

After the signal failure of the Delegates from the New York Univer- 
sity, to interrupt the progress of the Convention which assembled in New 
York, no further open opposition to the movement, which had been com- 
menced, was manifested previous to the next meeting, On the contra- 
ry, the President, Dr. Knight, shortly after the first meeting, issued an 
address to the profession on behalf of the committee appointed for that 
purpose, in which he set forth briefly and clearly the objects aimed at. 



176 Original Communications. [AnuL, 

and urged upon the profession the importance of a more full representa- 
tion at the adjourned meeting to be held in Philadelphia. The medical 
periodicals of the country, very generally, published the proceedings of 
the Convention in New York, and thereby aided much to bring the sub- 
ject to the notice of a much larger number of members of the profession. 
In the mean time, valedictory and anniversary addresses were written 
and widely circulated, discussing, more or less the subject of medical edu- 
cation, by Drs. John W. Francis, John Watson, and F. Campbell Stew- 
art, of New York; Drs. Samuel Jackson and Alfred Stille, of Philadel- 
phia ; Dr. S. H. Dickson, of Charleston ; and many others. The combi- 
ned influence of all these agencies, with the continued exertions of those 
who first put the ball in motion, served to awaken an almost universal 
interest in the subject. On the 5th cf May, 1847, the delegates ap- 
pointed by the Societies, Colleges, and other Medical Institutions 
throughout the several states, assembled in the Hall of the " Academy 
of Natural Sciences," in Philadelphia ; and were cordially welcomed by 
Dr. Isaac Hays, chairman of the committee of arrangements, who called 
the Convention to order, and nominated Dr. Jonathan Knight, of New 
Haven, as temporary Chairman. 

This nomination was unanimously confirmed, and Drs. Arnold, of 
Georgia, and Stille, of Philadelphia, were appointed Secretaries. A 'com- 
mittee for the reception of credentials of delegates was appointed, and 
another, consisting of one member from each state represented, to report 
the names of suitable candidates for election as permanent officers of the 
Convention. The first committee reported, as present, the names of 
near two hundred and fifty delegates, representing more than/or^ Me- 
dical Societies, and twenty eight Colleges, embracing Medical Institu- 
tions in twenty-two states and the 'District of Columbia. The committee 
on nominations, recommended for President, Dr. Jonathan Knight, of 
Connecticut ; for Vice-Presidents, Drs. Alexander H. Stevens, of New 
York, G-eorge B. Wood, of Pennsylvania, A. H. Buchanan, of Tennes- 
see, John Harrison, of Louisiana; and for Secretaries, Drs. R. D. Arnold, 
of G-eorgia, Alfred Stille, of Pennsylvania, and F. Campbell Stewart, of 
New York. These were all unanimously 'elected by the Convention. 
The first business of importance which engaged the attention of the Con- 
vention, was the reports of the committees appointed at the previous 
meeting in New York. Eeports were received during the first day, from 
Dr. John W^atson, of New York, Chairman of the Committee appointed 
u to prepare a plan of organization for a National Medical Association;" 
from Dr. John H. Griscom, of New York, Chairman of the Committee 



1854.] American Medical Association. 177 

appointed to consider the subject of procuring, from the state govern- 
ments, uniform and efficient laws for the registration of births, marriages, 
and deaths ; also from the same, on a general Nomenclature of Diseases; 
from Dr. James Couper, of Delaware, Chairman of the Committee " on 
Preliminary Education f and from Dr. Isaac Hays, on the subject of 
Medical Ethics. These several reports, except the last, were received, 
laid on the table, and ordered to be printed. 

During the following morning session, additional reports were received 
from Dr. John Bell, Chairman of the Committee appointed to prepare a 
code of Medical Ethics ; from Dr. James McNaughton, of Albany, Chair- 
man of the Committee appointed to consider the subject of the union of 
Teaching and Licensing in the same hands, signed by a minority of the 
committee ; and another report on the same subject, from Dr. Isaac Par- 
rish, of Philadelphia, signed by a majority of the committee. These re- 
ports were also received and ordered to be printed. The report of Dr. 
Couper, from the committee on the subject of " Preliminary Education/' 
was first taken up for consideration ; and after a free interchange of opin- 
ions, the report with the resolutions appended thereto, was adopted, and 
ordered to be published as a part of the proceedings of the Convention. 
The resolutions as adopted were as follow, viz : 

" Resolved, That this Convention earnestly recommends to the mem- 
bers of the medical profession throughout the United States, to satisfy 
themselves, either by personal inquiry or written certificate of compe- 
tent persons, before receiving young men into their offices as students, 
that they are of good moral character, and that they have acquired a 
good English education, a knowledge of Natural Philosophy, and the 
elementary Mathematical Sciences, including Greometry and Algebra, 
and such an acquaintance, at least, with the Latin and Greek languages 
as will enable them to appreciate the technical language of medicine, 
and read and write prescriptions. 

" Resolved, That this Convention also recommends to the members of 
the medical profession of the United States, when they have satisfied 
themselves that a young man possesses the qualifications specified in the 
preceding resolution, to give him a written certificate stating that fact, 
and recording also the date of his admission as a medical student, to be 
carried with him as a warrant for his reception into the Medical College 
in which he may intend to pursue his studies. 

" Resolved, That all the Medical Colleges in the United States be, and 
they are hereby recommended and requested to require such a certificate 
of every student of medicine applying for matriculation ; and when pub- 
lishing their annual lists of graduates, to accompany the name of the 
graduate with the name and residence of his preceptor, the name of the 



178 Original Communications. [April, 

latter being clearly and distinctly presented as certifying to the qualifi- 
cation of preliminary education." 

Moderate as is the standard of preliminary attainments required by 
these resolutions, there were some in the Convention who spoke in oppo- 
sition to its adoption, on the ground that it would prevent many young 
men of limited means from entering the profession, whose natural en- 
dowments would carry them to the highest rank, notwithstanding their 
inadequate preliminary preparation. On the other hand, it was admit- 
ted that there had been countries and periods in the world's history, 
when the obstacles, pecuniary and otherwise, in the way of gaining a 
knowledge of the ordinary branches of science, ' were so numerous as to 
preclude all but the favored few from its enjoyment. 

In such places, and at such times, the objection to the resolutions 
might have some force. But in our country of school-houses and almost 
unlimited facilities for acquiring a knowledge of, at least, the ordinary 
branches of learning, that young man who had not mental energy and 
perseverance enough to comply with the standard proposed in the resolu- 
tions, certainly had not enough to enable him to do justice to a profes- 
sion as extensive, intricate, and arduous as ours. 

The latter view was urged with much force by Dr. N. S» Davis, then 
a delegate from the New York State Medical Society. The resolutions 
were adopted by nearly a unanimous vote ; and the recommendations 
they contain have been re-affirmed by almost every meeting of the Ameri- 
can Medical Association since. 

The Convention next took up the report of Dr. R. W. Haxall, of Va. 
Chairman of the committee appointed to recommend a uniform standard 
of requirements for the degree of M. D. The several resolutions append- 
ed to the report were considered seriatim, and after receiving various 
amendments, were adopted as follows, viz : 

" Resolved, 1st, That it be recommended to all the Colleges to extend 
the period employed in lecturing from four to six months. 

2d, That no student shall become a candidate for the degree of M. D., 
unless he shall have devoted three entire years to the study of medicine, 
including the time allotted to attendance upon the lectures. 

3d, That the candidate shall have attended two full courses of lectures; 
that he shall be twenty-one years of age, and in all cases shall produce 
the certificate of his preceptor, to prove when he commenced his studies. 

4th, That the certificate of no preceptor shall be received, who is 
avowedly and notoriously an irregular practitioner, whether he shall pos- 
sess the degree of M. D. or not. 

5th, That the several branches of medical education already named in 
this report, (viz : Theory and practice of medicine, principles and prac- 



1854.] American Medical Association. 179 

tice of Surgery, general and special Anatomy, Physiology and Pathology, 
Materia Medica, Therapeutics, and Pharmacy, Midwifery, and diseases 
of women and children, Chemistry and Medical Jurisprudence,) be taught 
in all the Colleges, and that the number of professors be increased^to 
seven. 

6th, That it is required of candidates that they shall have steadily 
devoted three months to dissections. 

7th, That it is incumbent upon preceptors to avail themselves of every 
opportunity to impart clinical instruction to their pupils, and upon Medi- 
cal Colleges to require candidates for graduation to show that they have 
attended on hospital practice for one session, whenever it can be accom- 
plished, for the advancement of the same end. 

8th, That it be suggested to the Faculties of the various Medical In- 
stitutions of the country, to adopt some efficient means for ascertaining 
that their students are actually in attendance on their lectures. 

9th, That it is incumbent on all Schools and Colleges granting diplo- 
mas, fully to carry out the above requisitions. 

10th, That it be considered the duty of preceptors to advise their stu- 
dents to attend only such institutions as shall rigidly adhere to the re- 
commendations herein contained." 

Much opposition was manifested by some of those connected with the 
Colleges, to the adoption of the first of the foregoing resolutions. It was al- 
ledged that the great majority of medical students could not be kept in 
attendance on the Colleges continuously for six months ; there being many 
in all the Colleges who practically cut short even a four month's course, 
by coming late, or leaving before the close. This, together with all the 
other resolutions, were adopted, however, by large majorities ; and it is 
worthy of remark, that very few if any, were found to claim, that, less 
than six months was really sufficient to present the various branches of 
medical science with that fulness which ought to be enforced in a Col- 
lege course. 

The report on Medical Ethics, made by Drs. Bell and Hays, was very 
full and explicit, and was unanimously adopted by the Convention. The 
same was true of the reports of Dr. Griscom, on " a registration of births, 
marriages, and deaths/' and on " a nomenclature of diseases adapted to 
the United States, having reference to a general registration of deaths." 
These were all adopted, and may be found in the first volume of Trans- 
actions of the American Medical Association. Another subject which 
elicited discussion and much attention was, that embodied in the follow- 
ing resolution, viz : 

" Resolved, That the union of the business of teaching and licensing 
in the same hands, is wrong in principle and liable to great abuse 
in practice. Instead of conferring the right to license on Medical 



180 Original Communications. [April, 

Colleges, and State and County Medical Societies, it should be 
restricted to one board in each State, composed in fair proportion of the 
representatives from its Medical Colleges and the profession at large, and 
the pay for whose services, as examiners, should, in no degree, depend 
on the number licensed by them." 

It was stated in the preceding article on this subject, that this 
resolution was presented to the Convention in New York, by Dr. 
0. S. Bartles, and was referred to a special committee of seven, 
with directions to report at the meeting in Philadelphia. This com- 
mittee consisted of Drs. James McNaughton, of Albany, N. Y., and 
Professor in the Albany Medical College 5 J. R. Manley, J. W. Francis, 
and Thomas Cock, of New York 5 Isaac Parrish, of Philadelphia ; K,. 
Blakeman, of Conn.; and J. Cullen, of Ya. The chairman, Dr. Mc 
Naughton, made a report adverse to the general sentiment of the resolu- 
tion, but which did not meet the views of a majority of the committee. 

His report closed with the following resolutions, viz : 

" Resolved, That inasmuch as an opinion prevails to a considerable ex- 
tent in the profession, that certain abuses have crept into some of the 
Colleges — namely, that they confer degrees upon persons who have not 
fully complied with their own requirements, or on those who do not pos- 
sess the requisite amount of knowledge to entitle them to such distinc- 
tion, it is deemed expedient by this Convention, in order to satisfy the 
just wishes of the profession, and to remove just grounds of complaint, 
that such Colleges as do not already possess mixed boards of examiners, 
should consent to have associated with them, in the examinations for de- 
grees, some members of the profession not engaged in teaching, or other- 
wise interested in such institutions. 

u Resolved, That the number of boards for granting licenses in the 
several states, should be as limited as would comport with the conveni- 
ence of examiners and candidates in each state." 

Another report was made from the same committee, by Dr. Isaac 
Parrish, and signed also by Drs. J. E. Manley, J. W. Francis, and Tho- 
mas Cock. This report maintained in clear, yet conciliatory language, 
not only the liability to, but the actual existence of abuses in the granting 
of diplomas which were in themselves licenses to practice ; and the right 
of the profession to apply some appropriate remedy. Without any spe- 
cific recommendation, however, the report of Dr. Parrish concluded with 
the following preamble and resolution, viz : 

" Whereas, a general sentiment prevails in the medical profession, 
that the active competion existing among the Medical Colleges of the 
Union, has a tendency to lower the standard of professional requirements, 
and to depreciate the value of the degree ; and whereas, the facilities 
with which charters for Medical Corporations are obtained from our State 



1854.] American Medical Association. 181 

governments, exposes the medical profession to the continuance and in- 
crease of such abuses, inasmuch as these corporations possess alike the 
power of granting the license to practice ; therefore, Resolved, That in 
the opinion of this Convention, some additional checks to the exercise of 
this right should be established by the great body of the medical profes- 



sion." 



After considerable discussion, both the reports, and the resolutions ap- 
pended to them, were disposed of by the adoption of a resolution refet- 
ing the whole subject to the committee on Medical Education, with in- 
structions to report on the same, at the next meeting of the American 
Medical Association. 

Perhaps the most important subject which engaged the attention 
of this Convention, was the report of the committee on a plan for 
organizing a permanent National Association. This committee, con- 
sisting of Drs. John Watson, John Stearns, F. Campbell Stewart, 
and N. S. Davis, of New York; A. Stille, of Philadelphia ; W. H. Cogs- 
well, of New London, Conn.; and E. D. Fenner, of New Orleans, La.; 
reported in full, a Constitution designed to effect a permanent National 
organization. The committee adopted as the basis of organization, the 
principle of representation, by making the acting members of the Asso- 
ciation consist of Delegates from Medical Societies and Institutions, in 
accordance with a fixed numerical ratio. In the preamble attached to 
the Constitution, the purposes for which the Association is organized 
are declared to be, " for cultivating and advancing medical knowledge, 
for elevating the standard of medical education, for promoting the use- 
fulness, honor, and interests of the medical profession, for enlightening 
and directing public opinion in regard to the duties, responsibilities, and 
requirements of medical men, for exciting and encouraging emulation 
and concert of action in the profession, and for facilitating and fastening 
friendly intercourse between those engaged in it." 

To more certainly effect these objects, the committee deemed it impor- 
tant to hold out the strongest inducements for the formation of state 
and local Associations, which should be auxiliary to the national one. 
Hence, they so framed the Constitution as to make the great majority 
of the members, of the National Association, consist of Delegates from 
permanently organized State and County Medical Societies, throughout 
the Union. 

To ensure, also, a due share of the attention of the Association, to the 
cultivation of medical science and literature, the Constitution provided 
for the annual appointment of Standing Committees, each consisting of 
seven members, on the following subjects, viz : 

A committee on Medical Sciences ; on Practical Medicine; on Surgery ; 

::4 " . 



182 Original Communications. [April, 

on Obstetrics ; on Medical Education ; on Medical Literature ; and on 
Publication. The articles of the Constitution were considered separate- 
ly, and also various amendments, only one of which, however, proposed to 
alter essentially the basis or principle of organization. This was present- 
ed by Dr. Isaac Hays, of Philadelphia, and was as follows, viz : 

" Resolved, That the report be referred back to the committee, with in- 
structions to report a plan of organization in accordance with the follow- 
ing sketch. 

1st, The Society to consist of members to be elected by the Associa- 
tion, directly, or through its council. 

2d, Members, before admission into the Association, to sign a promise 
to conform to the laws of the Association. 

3d, Members who violate this pledge, to be liable to expulsion, and to 
be deprived of the rights of brotherhood. 

4th, For the appointment of a Council to consist of the officers of the 
Society, and of Councillors, to be elected annually, or all the for- 
mer, and a portion at least, of the latter, to be elected annually. The 
Councillors to have the general superintendance of the concerns and 
publications of the Association, and to report the proceedings of the As- 
sociation at its annual meeting." 

After considerable discussion, the proposition of Dr. Hays was lost, 
and the Constitution as reported by the committee, without any impor- 
tant amendments, was adopted by a large majority. 

The Convention then resolved itself into the " American Medical 
Association ;" and a committee consisting of one from each state repre- 
sented, was appointed to nominate officers of the Association for the en- 
suing year. The committee soon reported the names of the following 
gentlemen, who were unanimously elected, as follows : 

PRESIDENT, 

Dr. Nathaniel Chapman, of Pennsylvania. 

VICE-PRESIDENTS, 

Drs. Jonathan Knight, of Conn.; Alexander H. Stevens, of N. Y.; 
James Moultrie, of S. C.-; A. H. Buchanan, of Tenn. 

SECRETARIES, 

Drs. Alfred Stille', of Phila.; J. R. W. Dunbar, of Baltimore. 

TREASURER, 

Dr. Isaac Hays, of Philadelphia. 
Dr. Chapman, on being escorted to the President's chair, addressed 
the Association in a few very earnest and appropriate remarks. Provi- 
sion was made for appointing the several Standing Committees required 
by the Constitution, and also a committee of one from each state to act 
under the following resolution, offered by Dr. N. S, Davis, of N. Y, viz :■ 



L854.] American Medical Association. 183 

" Resolved, That a committee of one from each state represented in 
this Association, be appointed by the President, whose duty it shall be 
to investigate the Indigenous Medical Botany of our country ; paying 
particular attention to such plants as are now, or may be hereafter dur- 
ing their term of service, found to possess valuable medicinal properties, 
and are not already accurately described in the standard works of our 
country ; and report the same in writing, giving not only the botanical 
and medical description of each, but also the localities where they may 
be found, to the next annual meeting of the American Medical Associa- 
tion." 

After the adoption of the customary complimentary resolutions to the 
)fficers of the Convention, the committee of arrangements, &c, the Asso- 
3iation adjourned. The session in Philadelphia continued three days, 
and ended as it began, with the most cordial friendship among all its 
members, and a unanimous desire to elevate the character and extend 
the usefulness of the whole profession. In the foregoing brief sketch of 
the Convention which resulted in the formation of the National Associa- 
tion, I have by no means attempted to notice all its doings, but only 
such parts as were calculated to exert a general influence over the pro- 
fession, or to throw light on the organization and objects of the latter. 
ro the former, belonged the reports and resolutions adopted concerning 
i higher and more uniform standard of preliminary education ; more ex- 
tensive requirements for the degree of Doctor of Medicine ; the separa- 
tion of the teaching and licensing powers ; and the adoption of uniform 
registry laws : while to the latter belonged the formation and adoption 
of a Constitution. 

The attentive reader will observe that two radically different princi- 
ples were advocated as the basis of the National organization. The idea 
or principle entertained by the committee, and embodied in the Consti- 
tution as adopted by the Convention, was, that the National Association 
should emanate directly from the local medical organizations and insti- 
tutions, by making it consist of delegates appointed annually by such 
bodies, and thereby give it a legitimate claim to the character of a true 
representative of the whole profession. And to guard still further against 
any liability to become sectional or localized in its character, a provision 
was incorporated in the Constitution, prohibiting the holding of the an- 
nual meetings twice in succession in the same place. Two great leading 
ends were aimed at by the adoption of this principle of organization. 
The first was, that the recommendations of an Association thus constitu- 
ted, of delegates directly from the local societies and institutions of the 
profession throughout the whole country, would have more influence 
both with the profession and the public, than one organized on any other 



184 Original Communications. [Aprii,, 

plan. The second was, that it would constantly hold out a strong in- 
ducement to form and sustain in active operation, state, county, and city 
Associations in every state in the Union. 

The other principle was embodied in the proposition of Dr. Hays, 
already quoted. It proposed an organization, the members of which 
should be elected by itself, either directly, or through a board of 
Councillors; thereby making it essentially ^independent of the state 
and local Societies and Institutions. It was claimed for this, that it 
would give the Association greater stability, by rendering its mem- 
bership more select and permanent, and thereby make it more 
efficient as an Association, for the direct cultivation of medical 
science. The advocates of this plan have never been fully satisfied with 
the present Constitution of our National Association, but have almost 
annually sought to procure in it essential modifications. Thus far the 
original principle has been sustained, and the extent to which it has an- 
swered the expectations of its advocates, will be seen in the sequel. 
Another act illustrating the disposition of the originators of the Associ- 
ation, to make it as truly national as possible, and as free from mere in- 
dividual preferment, was the selection of the first President of the Asso- 
ciation. It is almost universally customary in forming and carrying on 
social organizations, to elect as officers, those who have been most active 
and efficient in promoting the objects sought. But the selection of Dr. 
Chapman was based on no such principle. He was selected solely be- 
cause, from his age, his high attainments, and his position as one of the 
oldest and most eminent teachers in the union, he stood appropriately at 
the head of the whole profession. Hence the selection was at once an 
act of liberality, and a just tribute to age and deserved eminence. Be- 
fore adjourning, the Association selected Baltimore as the next place of 
meeting, and the Constitution fixed the time, on the first Tuesday in 
May of each year. 

MEDICAL JURISPRUDENCE, 

Plea of Drunkenness. —By I. S. Mulford, M. D. 
Drunkenness may be considered in two different aspects, eitjier in 
its immediate effect upon the subject himself, or in its remoter conse- 
quences, when the subject has become an offender against others.' The 
former of these falls naturally, and almost wholly, within the domain of 
medical science; but the latter presents a subject for medico-legal inqui- 



1854.] Mulford — Plea of Drunkenness. 185 

ry, and it is in this latter aspect chiefly, that it is here to be considered. 
Nor is it proposed to examine the entire extent even of this view, but 
rather to exhibit the decisions of law, and the teachings of medicine, in 
their bearing upon a single point. 

The laws relating to drunkenness have varied greatly at different 
times, and in different countries. In some instances it has been held, 
that, as drunkenness is a state resulting from a voluntary act, and is in 
itself am offence, it should never be allowed as an excuse for crime, but 
on the contrary, that the punishment due to such crime, should only be 
greater. It was prescribed by a famous law-giver in Greece, that he who 
committed a crime when drunk, should receive a double punishment, one 
for the crime itself, and another for the drunkenness. According to the 
Roman practice, on the contrary, drunkenness was generally considered 
as taking away from a criminal act the quality of malicious design, 
and in consequence punishment was lessened or remitted.* 

An examination of the laws and practices of modern times will show, 
that differences scarcely less striking, are yet to be found. In most, or in 
many of the countries of Europe, a distinction of cases is admitted ; drunk- 
enness is allowed as a ground of exculpation in most instances ; but an 
exception is made where it is produced with a view, and for the purpose 
of committing crime. But neither in England nor in France is drunk- 
enness allowed in any case, as a plea for criminal acts. The English law 
considers the drunkard as being a " voluntarius daemon,'" and declares 
that "where drunkenness is voluntary, the subject shall have no privi- 
lege by his want of sound mind ; but shall have the same judgment for 
his crimes as if he were in his right senses." In our own country, the 
general theory of law is nearly the same as in England. In an early 
case it was said, that drunkenness can never be received as a ground to 
excuse or palliate such an offence, (homicide) and this is not merely the 
wild opinion of a speculative philosopher, the argument of counsel, or the 
obiter dictum of a single judge; but it is a sound and long established 
maxim of judicial policy, from which perhaps a single dissenting voice 
cannot be found. But if no other authority could be adduced, the uni- 
form decisions of our courts from the first establishment of the govern- 
ment, would constitute it now a part of the common law of the land.f 

Still, although the theory of law is as above stated, yet, neither in En- 
gland nor in our own Country, has this doctrine been carried out to the 
full extent, in actual practice ; some limitations of the general rule hav- 

* Ray's Jurisprudence of Insanity, p. 449. 
f See Wharton's Criminal Law, p. 46. 



186 Original Communications. [April, 

ing been made in certain cases. As in drunkenness the mind is much 
disordered, the question has been made, whether this disorder should not 
be considered, for the purpose of determining the real condition of the 
party, at the time of committing an offence. In such a case as homicide, 
the particular complexion of the offence is frequently made to depend 
upon the mental condition of the offender at the time, and hence it be- 
comes important, that this circumstance should be closely inquired into. 
Such disorder of mind may exist as to release from all responsibility, 
and consequently from all punishment, as in cases of actual decided in- 
sanity ; or where there is no such disorder as will remove responsibility, 
there yet may be something in the mental condition that calls for regard 
in estimating crime. Is the disorder attending drunkenness to be exclud- 
ed entirely from all such regard ? The general tenor of law, upon this 
point, has already been set forth, and in conformity with this, a high 
authority, (Story) whilst speaking of the mental affections which may be 
allowed as excusing crime, remarks, that "an exception is, when the crime 
is committed by a party, whilst in a state of intoxication ; the law not 
permitting a man to avail himself of the excuse of his own gross vice and 
misconduct, to shelter himself from the legal consequences of such 
crime." By another authority it is said, that "it is a well known and 
salutary maxim of our laws, that crimes committed under the influence 
of intoxication, do not excuse the perpetrator from punishment. The 
temporary alienation has been voluntarily induced, and the individual is 
the more inexcusable, if, by previous experience he has learnt, that his 
angry passions are influenced through its means."* 

Here then it would seem, that the disorder of drunkenness, whatever it 
may amount to, is to be quite excluded from notice. Nevertheless, as alrea- 
dy intimated, this principle of total exclusion has not been fully sustained 
in practice ; it has only been adhered to so far as it applies to an abso- 
lute defence ; but it has not been so maintained as to prevent the disor- 
der in question, from being admitted, in many cases, as a plea in miti- 
gation. 

In England, it was held by a learned Judge, that where, as on a 
charge of murder, the material question is, whether an act was premedi- 
tated, or done only with sudden heat and impulse, the fact of the party 
being intoxicated, is a circumstance proper to be taken into consideration. f 
Many similar decisions have been made in our own courts. The effect 
of such decisions is most clearly seen where, as in many of the American 

* Beck's Medical Jurisprudence, p. 805. 
f See Wharton, p. 47. 



1854.] Mulford — Plea of Drunkenness. 187 

States, the crime of murder is made to be of. different degrees, and the 
punishment to vary according to the degree. So it has been said, that 
as it (drunkenness) clouds the understanding and excites passion, it may 
be evidence of passion only, and of want of malice and design, and if it 
be satisfactorily established, it may lower the grade of homicide from 
murder in the first, to murder in the second degree.* 

In a very recent case in Pennsylvania, it was said, that murder as de- 
fined by the legislature was a statutory offence, that it was divided into 
degrees, and the essential elements specified with accuracy and certainty. 
That in order to constitute murder in the first degree, (save the enume- 
rated exception mentioned in the act), it was necessary, that it should be 
perpetrated wilfully, deliberately, and with premeditation, and that 
therefore, if one accused of the crime was in a condition, arising from 
any cause whatever, which deprived him of the power of forming a wil- 
ful, deliberate, and premeditated design, he could not be convicted of 
murder in the first degree, and that it was immaterial, whether that con- 
dition was caused by the folly and vices of the accused, or by the act of 
God.f Here then, it will be perceived, the disorder of drunkenness is 
placed upon the same ground, as a plea to be considered and examined, 
as insanity from any cause whatever. It is to be noticed, however, that 
it is not the mere bare fact of the existence of drunkenness, that is re- 
quired to be shown ; it is such a degree of disorder from this cause as 
will incapacitate the subject for the performance of any wilful, deliberate 
act. Whether such incapacity may result from this cause, in any case, 
or has so resulted in any given case, are the points to be determined. 

The mental condition of the drunkard is modified a good deal by cir- 
cumstances, such as the quality of the article that has been used, special 
peculiarities of constitution, and the period for which the state has con- 
tinued. In most instances, the earliest decided indication of change will 
be, a kind of quickness or acceleration of all the movements of mind; the 
faculties appear to be aroused and wrought up to greater activity and 
vigor. At a later period, this activity increases, but becomes irregular, 
and some of the faculties especially, become highly excited, so that har- 
mony of movement is lost ; and this disproportionate excitement is most- 
ly in the lower manifestations, the passions and animal propensities. 
Thus the intellectual powers become obscured, having lost their relative 
force, and being no longer able to keep the impulses in check, the man 
becomes mischievous, or foolish, or brutal, according as his temperament 

* Wharton, p. 47. 

t Allison, J. in " Commonwealth v. Capie and Emmons.'' 



188 Original Communications. [April, 

or surrounding circumstances may impel him. At a still later period, 
there is a decline of action, dullness succeeds, and partial, or total insen- 
sibility closes the scene. After a longer or shorter time, the subject re- 
turns to his former state, and no trace of the previous disorder may re- 
main. 

But in order to arrive at accuracy of judgment, in regard to mental 
capacities during this period, the appearances just mentioned must be 
noticed somewhat more closely. During the early period, that of mode- 
rate and general excitement, there can be no doubt that the faculties of 
knowing, judging, and determining, retain their relative force in a suffi- 
cient degree, to give a capacity for deliberate resolve ; it is the state of 
tumult and disorder that follows, that requires especial attention. At this 
period, it has been said by a high authority, u the man is entirely beside 
himself, memory and judgment having abandoned him; he acts as if he 
lived only for the present, with no idea of the consequences of his actions, 
nor their relation to one another ; the past has gone from his mind, and 
he cannot be influenced by considerations which he no longer remembers. 
He conducts himself as if no control over his actions were necessary ; the 
slightest provocation is sufficient to awaken the most unbounded rage. He 
is therefore, not unlike the maniac, and can be responsible for his actions 
only so far as he is for his drunkenness."* 

With such a view as this, the idea of deliberate design, of premeditat- 
ed action, would not seem to be consistent ; and indeed, if all regard to 
the cause were excluded, an individual affected as here described, could 
not be held to be at all responsible for his acts. 

But the picture here given, is certainly strongly drawn. It may be 
doubted, whether at any period, short of actual or approaching insensibi- 
lity, the memory and judgment are altogether lost; in strict language, 
the case is not so much one of positive deprivation of these faculties as of 
imperfect, and, in the last stages, of suspended action. Nor is this state 
of imperfect action one of absolute fixedness ; it is liable to some fluctu- 
ation and change; it is subject to change from the operation of medici- 
nal substances upon the body, and also, as it is stated, from the influence 
of powerful impressions made on the mind. Cases are mentioned, in 
which, by an unexpected shock from some piece of intelligence, the 
drunkard has been brought, almost at once, to his senses. If this be so, 
may it not be believed, that the slumbering faculties may be roused to 
activity on other occasions ; that if some motive, calculated to produce a 
profound impression, should act upon the mind, it may meet with an an- 

*Ray, p. 448. 



1854.] Mulford — Plea of Drunkenness. 189 

swering power. This is not difficult of belief, if the measure of power 
necessary to deliberate action, be that which is given by a late authority. 
It is laid down by Judge Allison, u that the intoxication that would avail 
as a defence, must be that degree of drunkenness which deprives one of 
the power of judging of his acts and the legitimate consequences result- 
ing therefrom, as of understanding the relation between cause and effect. 
That if the defendants knew what they were about, understood their own 
language, that the weapon exhibited was a knife, and that a blow with it 
in a vital part would cause death, then they had sufficient consciousness 
of their own actions, and of right and wrong; or in other words, were 
sufficiently sober to form a deliberate design."* Judged by this standard, 
but very few, if any could escape on the ground of a lack of capability ; 
if the evidence was such as to show deliberation, the plea of a want of ca- 
pacity for it, could, according to the rule above given, scarcely ever avail. 
But it ought to be considered that, as already remarked, the intellectual 
faculties are obscured and comparatively dull, at this period, and the evi- 
dence that they have been in operation, so as to originate a settled plan 
of action, should be strong and clear. Far more probable will it be, that 
the man has acted from passion and heat, and this is the view to be 
taken, unless the evidences of a deliberate purpose, are such as to leave 
no room for doubt. 

It. appears then, from what has been said, that drunkenness can in no 
instance be admitted as an absolute defence, in cases of homicide ; nei- 
ther can it serve as a plea in mitigation, provided the facts are such as 
to show deliberation in the aet, there being nothing in this state, which 
absolutely and of necessity, incapacitates the subject for such acts. This 
plea then, even according to the present meliorated views, can have no 
great force ; its utmost effect will be to show, that the party accused of 
crime, by reason of the state he was in at the time, was peculiarly liable 
to be influenced by passion and impulse; and thus a presumption may 
arise, which, if not met by positive evidence, may turn the scale so as to 
save from the highest penalty. 

But there is a still further view of this subject to be taken. It has 

* In Commonwealth, v. Capie and Emmons. In this case the prisoners had been 
much intoxicated, and had at that time exhibited deadly weapons, and intimated a 
purpose to use them upon an individual in the vicinity, Starting out under these cir- 
cumstances, they met with another person, whom they fell upon, and wounded so that 
he died in a very short time. Upon the trial, the judge explained to the jury what 
might be considered sufficient evidence of a capacity for deliberate action, and set 
forth the facts and circumstances. It was then left for the jury to determine, whether 
the prisoners had in their condition been able to form, and had formed a deliberate de- 
sign to commit murder, or not. A verdict of murder in the first degree was rendered. 

25 



190 Original Communications. [April, 

been said, that the disorder of drunkenness, after continuing for a longer 
or shorter period, passes entirely off, and that the subject is then left in 
bis former condition. But, after a protracted course of such abuse, this 
entire restoration may not occur ; the consequences may run on from one 
time to another, and thus a state of permanent disorder may come to be 
produced. The new condition which has thus arisen, may be easily ac- 
counted for. The brain having been often excited, permanent irritation 
in that organ is at length established, and this may readily be urged, by 
continued indulgence, into actual inflammation, with its frequent conse- 
quence, watery effusion.. A degree of mental disturbance will be the 
necessary effect of these changes, but it will vary in form, according to 
the pathological condition of the parts that have become affected. In 
some instances, there will be an alteration rather in the general manner 
and character, than in any special manifestation ; the man has become 
unlike himself in many respects ; his intellect exhibits less vigor, and 
his passions greater force ; he yields more readily and frequently to any 
temptation to indulgence, and such indulgence is productive of more de- 
cided effects. Some authorities indeed, have advanced the doctrine, that 
in many such cases, the power of resistance is weakened and sometimes 
entirely lost, so that intoxication itself may become an involuntary act ; 
that the appetite for drink existing, the desire is yielded to at once, the 
subject being entirely incapable of self-controL 

A diseased condition of this kind, it is represented, may be either uni- 
form in its course, or there may be intervals of seeming amendment, in 
which the subject appears to regain his power, but only after a longer or 
shorter time to suffer a relapse, falling back into his former, or perhaps 
into a worse condition. This disorder, whether permanent or periodical^ 
has been designated by the term dipsomania. 

This doctrine of involuntary drunkenness, however, has not yet met 
with general acceptance, and it is not known that it has ever been pre- 
sented distinctly in courts. But it is hardly to be doubted, that there is 
a state of disease, nearly akin to insanity, that is the effect of frequent 
intoxication, and which, in its turn, may aggravate that from which it has 
arisen. Cases of this kind will give rise to extreme embarrassment, 
when crime has been committed in a paroxysm of drunkenness ; to draw 
the line between intoxication and insanity, will then be a difficult task, 
even to the most experienced and discerning.* 

*Beck has a remark bearing somewhat upon cases of this description. " If spirit- 
uous liquors" he says, "exercise such an influence as to render it doubtful concerning 
the state of mind at the time, we may reasonably infer that the alienation is becoming 
permanent." 



1854.] MULFORD — Plea of Drunkenness. 191 

There are other cases, in which the marks of mental derangement have 
become so decided and clear, as to remove all doubt, the line between 
healthy and disordered action, having been fully passed over. The dis- 
ease that has supervened has now become fixed, and exercises at all times 
a manifest influence upon the operations of mind. The habit which has 
caused this state, may still be continued, and be followed by its usual 
effects, but this can give rise to little obscurity, because the situation of 
the man during the intervals of abstinence, will furnish sufficient ground 
for an opinion as to the source of his acts. The occasional disorder need 
scarcely be brought into view, when the permanent condition of the sub- 
ject, gives a sufficient clue to his course. 

Beside the disorders above mentioned, there are others which arise 
from the use of intoxicating drinks, but in a manner not so direct, oc- 
curring in some cases only, and as a remote effect. The best known of 
these affections is, that which is usually denominated mania a jpotu. 
This has frequently become the subject of investigation in courts, on ac- 
count of the commission of crime whilst under its influence, and impor- 
tant, though not entirely concurrent, decisions, have been made in regard 
to it. An early case in this country, that excited general attention, oc- 
curred in the state of Ohio. It was that of a man on trial for the mur- 
der of his wife. The evidence was such as to leave no doubt as to the 
fact of the murder, and the defence set up was mania a potu. From 
medical and other testimony, the existence of this disorder, at the time 
of the murder, was made sufficiently clear, and hence, the only question 
was, in what light this disorder was to be considered in regard to a re- 
sponsibility for acts. Necessarily involved in this question was the in- 
quiry, whether there was a material distinction between the disorder of 
drunkenness, and the affection then under notice ; no one maintaining 
that drunkenness could be allowed as an excuse in such a case. But it 
was said that mania a potu was not essentially or usually connected with 
drunkenness, but was only an accidental effect, not one which the sub- 
ject had knowingly and voluntarily brought upon himself by his own 
act; and of consequence, that this affection should be considered dis- 
tinctly, and the case in question be examined as though it were simply 
one of insanity. On the other hand it was contended that it was to be 
regarded merely as a case of drunkenness. In the charge from the 
Court, the facts of the case were presented, and an intimation given, that 
the mental condition of the prisoner was to be determined according to 
the ancient test, a capacity to judge between right and wrong. The jury 



192 Original Communications. [April, 

believing that such a capacity existed, rendered a verdict of murder in 
the first degree.* 

Not far from the same time, a similar case was tried in the Circuit 
Court of the United States. It was that of the master of a ship who 
was indicted for the murder of his second mate. Here too, the facts 
were clearly brought out. The prisoner had been drinking excessively, 
but afterwards had thrown all the liquor in the ship overboard, and con- 
sequently nothing of the kind was within his reach. Two or three days 
afterward he became unwell, and finally exhibited all the symptoms of 
mania a potu, and during the continuance of this state, he committed 
the murder in the presence of divers persons. In this case, some impor- 
tant questions which had been passed over in the one before mentioned, 
were fully considered and decided. Justice Story said that " the ques- 
tion made at the bar is, whether insanity whose remote cause is habitual 
drunkenness, is, or is not, an excuse in a court of law, for a homicide 
committed by the party while so insane, but not at the time intoxicated, 
or under the influence of liquor. We are clearly of opinion that insani- 
ty is a competent excuse in such a case. In general, insanity is an ex- 
cuse for any crime, because the party has not the possession of his rea- 
son, which includes responsibility. An exception is, when the crime is 
committed while the party is in a state of intoxication, and while it lasts, 
and not as in this case a remote consequence superinduced by the ante- 
cedent exhaustion of the party, arising from gross and habitual drunk- 
enness. However criminal, in a moral point of view, such an indul- 
gence is, and however justly a party may be responsible for his acts, 
arising from it, to Almighty God, human tribunals are generally re- 
stricted from punishing them, since they are not the acts of a reasonable 
being. Had the crime been committed by the prisoner whilst in a state 
of intoxication, he would have been liable to be convicted of murder. 
As he was not then intoxicated, but merely insane from an abstinence 
from liquor, he cannot be pronounced guilty of the offence." The jury 
returned a verdict of not guilty. 

In a subsequent case, which was tried in the state of Maine, the gene- 
ral features were very similar to those already noticed, and the Court in- 
structed the jury, that if they believed the prisoner was laboring under 
insanity at the time of the commission of the act, it was not necessary 
to go into an inquiry as to the particular kind or species. Here too there 
was an acquittal. 

* North American Medical and Surgical Journal, No. xvi. Ray's Jurisprudence 
of Insanity, p. 465. 



1854.] MuLFORD — Plea of Drunkenness. 193 

These decisions would seem to have established the principle, that the 
derangement of mania apotu may be urged/ and may serve as a com- 
plete defence in criminal cases. And for such a distinction between 
this disease and drunkenness, there would seem to be sufficient reason : 
there being a most obvious difference not only in regard to origin, but 
also in the character of the mental affections. In mania a jpotu, the dis- 
order is of quite a different kind from that in drunkenness, as well as of 
far longer duration. 

A class of cases exists, in which there is a diseased condition, not 
arising at all from drunkenness, but which may yet became complica- 
ted with it, and a combined effect be presented that may prove extreme- 
ly embarrassing. The following case may serve as an illustration of the 
class. 

"William McDonough was indicted and tried for the murder of his 
wife, before the Supreme Court of the state of Massachusetts, in Novem- 
ber, 1817. It appeared in testimony, that several years before, he had 
received a severe injury of the head, that although relieved of this, yet 
its effects were such as occasionally to render him insane. At these pe- 
riods he complained greatly of his head. The use of spirituous liquors 
immediately induced a return of the paroxysms, and in one of these, 
thus induced, he murdered his wife. He was, with great propriety 
found guilty. The voluntary use of a stimulus which he was fully 
aware would disorder his mind, fully placed him within the power of 
the law."* 

The above narrative containing but few particulars, can only be judg- 
ed of from its general aspect ; the case was one of much delicacy, and it 
may not be proper, without fuller knowledge, to pronounce, that the 
verdict given, was not quite warranted. But it is clear that there was 
much in the man's disorder beside that which had resulted from his 
own act. If it cannot be supposed that the previous affection would 
have led to the commission of the act without the stimulus of drink, it 
still may be safely concluded that, on account of his previous condition, 
the effect of intoxicating drink upon him was entirely unusual, and 
therefore not such as might have been anticipated; not such as one 
might say he had deliberately brought upon himself by his own act. The 
case, indeed, is stated in such a manner as to convey the idea, that in- 
sane attacks, from the same cause, had frequently occurred ; and it might 
be alleged, indeed it is alleged, that such experience had given warning 
sufficient, and had taken away all ground for excuse. But had the act 

* Beck's Medical Jurisprudence. 



194 Bibliographical Notices. [April, 

in question been committed, as surely it might have been, in the first of 
these attacks, there would then have been no foundation for the argu- 
ment from experience. And besides, though insanity should occur in 
connexion with drunkenness ever so frequently, it still cannot be regard- 
ed as properly belonging to the paroxysm, and therefore should hardly 
be brought within the very same rule, in regard to responsibility for acts. 
In reference to cases of this nature, it has been said, that " if either the 
insanity has supervened from drinking, without the panels being aware 
that such an indulgence in his case leads to such a consequence ; or if it 
has arisen from the combination of drinking with a half crazy or infirm 
state of mind, or a previous wound or illness, which rendered spirits fatal 
to his intellect, to a degree unusual in other men, or which would not 
have been anticipated, it seems inhuman to visit him with the extreme 
punishment which was suitable in the other case. In such a case it is 
proper to convict ; but in consideration of the degree of infirmity proved, 
recommend to the royal mercy.''* 



BIBLIOGRAPHICAL NOTICES. 



The Elements of Materia Medic a and Therapeutics. By Jona- 
than Pereira, M. D., R K. S., L. S. Third American Edition, 
enlarged and improved, by the Author. Edited by Joseph Carson, 
M. D., &c, Vol. II. Philadelphia, Blanchard and Lea, 1854. (pp. 
1226.) 

None the less welcome, because so long expected, comes this second 
volume of the great treasury of pharmacological learning. When Dr. 
Pereira commenced the compilation of this superb work, he appears to 
have been resolved not only to exhaust the entire field of medical litera- 
ture in regard to his topic, but to use every aid that could be furnished 
by botany, chemistry, and the microscope, and in addition, to cultivate 
a thorough knowledge of the Drug-trade, in all its various ramifications. 
The mystifications produced, in many instances, by the obscurity of the 
channels through which drugs reach us, but more frequently by their 
fraudulent adulterations, imitations or substitution, and monopoly, con- 
stitute a study of themselves, and one for the prosecution of which the 
peculiar relations of Dr. P. to commercial interests in the city of London, 
gave him unusual facilities. All these sources of information he explored 
with the most faithful energy, and the result has been the most complete 
and thorough treatise on the Materia Medica extant, in any language. 
If liable to any objection, it is that of superabundant richness. The stu- 

# Alison's Criminal Law of Scotland. See Ray, p. 459. 



1854.] Bibliographical Notices. 195 

dent is overwhelmed with the copiousness of the material presented, be- 
ing left without a guide to distinguish between the articles of present 
practical importance and those seldom or never used. Hence it has been 
said to be a better book for teachers than for pupils ) and some prac- 
titioners have hesitated to make it their text-book or to put it into 
the hands of their office students. We can understand this hesita- 
tion on the part of those who are afraid of learning too much on the sub- 
ject. All others, we ar/prehend, will rejoice to possess this full store- 
house of facts, if only for the sake of reference. For it is to be remem- 
bered, that whatever Dr. P. asserts positively may be relied on implicit- 
ly. There never was a writer more cautious in his statements, or who 
would cling to a difficult question more tenaciously until he had master- 
ed it. The repeated interruptions to the appearance of this revised edi- 
tion, were produced by his searching into points requiring elucidation, and 
which he would not pass by until satisfactorily settled. The first volume 
of the present American edition, was issued by Lea& Blanchard in 1851 ; 
at which time it was announced that the second volume would appear in 
a few months. Yet its revision had not proceeded beyond the article 
Cinchona, at the time of the author's death, in January 1853. Consid- 
erable delay had occurred while revising his history of the Cardamoms 
and Turmerics — not matters of great practical moment, but sufficiently 
important in the estimation of Dr. P. to be treated correctly at any cost. 
But the principal interruption was at the section on Cinchona, which has 
been almost entirely re-written, with the addition of a large mass of new 
and interesting matter. 

It is not within the the scope of a notice like the present, to enume- 
rate the changes and additions in such a work. One or two may be in- 
dicated, however, to show that this is a revision and not a mere reprint. 
Thus yeast, (Cervisise Fermenturri) which, in the last edition was dis- 
patched in one page as an appendix to Sordeum, becomes an independent 
article of seven pages, illustrated by eight wood-cuts of microscopic sub- 
jects. Yeast is shown to be a minute cryptogam, and " to consist of 
globose, more or less ovoidal, ellipsoidal or somewhat pyriform, transpa- 
rent, nucleated cells." The subject of ergot was treated in the former 
edition more satisfactorily than in any other treatise we know, yet even 
this has been improved by the addition of a microscopic investigation of 
the intimate structure of the sound and ergotted grains; positively esta- 
blishing the opinion that the ergot is a diseased condition of the seed, 
produced by the presence of a parasitic fungus, the Oidium abortifa- 
cens. Among the additions of value, we may mention the Kwosso 
(Br ay era anthelmintica), and gutta-percha tree, (Isonanclra gutta~) ,hoih 
of which are described and figured. The author adopts with commenda- 
tion, the Dublin method of obtaining valerianic acid, and the valerianates, 
by the oxidation of fusel-oil with a mixture of bichromate of potassa 
and sulphuric acid. The article on Cinchona contains an immense 
amount of new and valuable matter, in reference to the botany, commer- 
cial history, and chemistry of this indispensable remedy, for which we 
must refer the reader to the volume itself. He will there find much of 



196 Bibliographical Notices. [April, 

his old creed about barks, rather rudely dispelled. It will no longer do 
to confine the actively medicinal barks to a few ports of the Pacific, nor 
to indicate Cortex Calisaya as the sole source of quinia. Our easy meth- 
od of disposing of all the barks from the Spanish main as " Carthagena," 
and therefore valueless, must be abandoned. Dr. P. recognizes twelve 
varieties of Cinchona ; the first being the Bolivian bark or Calisaya (co- 
vering certain others which he calls Pseudo- Calisaya.') Of the remain- 
ing eleven, four are New Grenada barks, which reach us by the way of 
the Rio Magdalena, and are known as Carthagena and Maracaibo barks. 
The variety known as Pitaya (hard, yellow Carthagena) is said to be es- 
pecially rich in alkaloids. The Coqueta variety has yielded as high as 
133 grains of sulphate of quinia to the pound. The excessive price of 
the Calisaya causes these barks to be employed, and we are of opinion 
that most of the quinia sold in our shops of late, both American and im- 
ported, is from this source. It becomes then a question of immense im- 
portance to decide whether the alkaloid obtained is really quinia, or at 
any rate, all quinia. Br. P., and others seem to have no doubt of the 
fact. Gruibourt found 1000 parts of Pitaya to contain 11 parts sulph. 
quiniae, and 23 cinchonia — exceedingly rich. The poorest specimen of 
Coqueta bark examined by Howard and Hindsley, of London, yielded, it 
is said, 32 grains sulph. quiniae to the pound. Others, however, have 
thought that the alkaloid thus obtained, is not quinia proper, but the an- 
alogous substance to which the name of quinidina has been given, and 
which is said, although identical in therapeutic power with the former, 
to require to be given in a much larger dose. If this be true, the very 
general complaint we have recently heard of the inefficiency of the com- 
mercial quinia, may be explained without resorting to the hypothesis of 
intentional adulteration. It is desirable that this important topic should 
be thoroughly investigated and speedily settled. 

As already intimated, the revision of the work was left incomplete at 
the sudden decease of the author. The remaining portion has been re- 
vised by Drs. Alfred S. Taylor and G-. Owen Bees, who have performed 
their part faithfully and learnedly. The American edition has been is- 
sued under the care of Professor Carson, whose additions, although not 
numerous, are always judicious and valuable. 



A Treatise on Acute and Chronic Diseases of the Neck op the 
Uterus. Illustrated with numerous plates, colored and plain. By 
Charles D. Meigs, M. D., &c. Philadelphia, Blanchard and Lea, 
1854. (8 vo. pp. 116). 

This work is a reproduction of the report on Diseases of the Cervix 
Uteri, made to the American Medical Association at its New York Meet- 
ing, and to be found in the Transactions for May, 1853. It has, there- 
fore, been already before the public, but its present form will give it a 
wider circulation, which it well deserves. It is not liable to the charge 
of diffuseness, which will justly lie against others of its author's produc- 
tions, but contains a large mass of valuable matter in a small space — 
Some points are touched even more cursorily than we could wish, consi- 



1854.] Bibliographical Notices. 197 

dering that they are subjects of professional disagreement and even con- 
troversy. 

The practitioner will find an especial interest in the remarks upon Leu- 
corrhoea and the use of the Speculum Uteri. Every sentence of this por- 
tion of the book is filled with valuable practical suggestions. Dr. M. refers 
to the popular notion of the debilitating effects of fluor albus, to show 
that the languor and debility are not owing to the mere loss by secre- 
tion, (which is totally inadequate, and may occur profusely from the va- 
ginal mucous surface without any such effect,) but is a sympathetic re- 
sult of disease of the cervix. His remarks, as to when and how the spe- 
culum is to be used, display judgment and moderation. All ques- 
tions which, like this, involve considerations of professional morality, 
must be left, in a great measure, to the individual conscience and right 
feeling of the practitioner. If he is imbued with the principles of the 
Christian gentleman, his action will be safe and proper. If, on the 
contrary, he is false, dishonest, and an extortioner, no rules will bind 
him. That the speculum has been much abused, there is no doubt. 
That the extreme sensitiveness of women, in regard to the threatenings of 
uterine disease, has been used to make them submit to unnecessary ex- 
posure and uncalled-for treatment, is, we fear, susceptible of proof. That 
serious errors of diagnosis have been committed in mistaking discolorations, 
hypertrophied mucous]crypts, &c, for ulcers, is equally undeniable. Still 
there are cases of diseases of the os and cervix, in which metroscopic ex- 
amination gives a clearness of diagnosis, and an efficacy of treatment im- 
possible without it. The remedy for the existing difficulty— for there is 
no disguising the fact, that this subject has caused a serious difficulty in 
the professional mind — is for the profession to set their faces, like a flint, 
against the speculum specialty as an arrant quackery, and to let us see 
the educated and skilful use of the instrument in the hands of every man 
who pretends to treat uterine disease at all. We agree with Dr. M. in 
his condemnation of the valvular speculum. The tubular form is cer- 
tainly preferable, when the object to be inspected is the uterus. Dr. M. 
recommends a plain silver tube, blackened on the inside. The last point 
is peculiar, and deserves notice. Dr. M. asserts that the irregular reflec- 
tion from a bright surface, causes the appearance of red spots and patches, 
which may be mistaken for disease. He is right, according to all rules 
of Optics ; and it only remains to determine, whether, in such blackened 
tube, a sufficient amount of light can generally be made to reach the bot- 
tom, to secure perfect vision. We also perceive that Dr. M, steps aside, 
(p. 97)^ to have his customary, kick at the abdominal supporter, which, 
he admits, is still prescribed by men eminent in the profession. Here is 
another matter, which we wish was definitely settled. On the one hand, 
our principal obstetric authorities condemn this instrument in the most 
unmeasured terms; while, on the other, the great body of the profession 
continue to use it, simply because they think they find it to answer the 
purpose for which it was intended. We would respectfully suggest this 
to some of our able contributor as a topic for research, and will gladly 
open our columns to its fair and full discussion. 
26 



198 Bibliographical Notices. [April, 

The illustrations of the work are mostly colored lithographs, and al* 
though liable to some criticism, they are of superior order. In some r 
the artist is to blame, his work being coarse, smutted and wanting in dis- 
tinctness of outline. The faithfulness of the delineations demands the 
highest praise. The writer of this notice was the attending physician of 
the lady whose autopsy furnished the dissection figured in (pi. 22). He 
was aware that Dr. M. made a pencil sketch of it in his note-book, with 
the measurements attached; but he did not know that any further use 
would be made of it. Yet he recognized the appearance the moment he 
opened the book, although a couple of years had elapsed since the au- 
topsy. A more striking proof of accuracy could not well be advanced,, 
and it therefore, gives us pleasure to bear this testimony. 

Pneumonia; its supposed connection, Pathological and Etiological, with 
Autumnal Fevers; including an inquiry into the existence and 
morbid agency of Malaria. By R. La Roche, M. D., &c. Phila- 
delphia, Blanchard & Lea, 1854, (8vo. pp. 502.) 

We regret that our limits prevent our giving its deserved fullness of 
notice to this excellent work, which we regard as one of the most valua- 
ble ever issued from the American press. Nothing, short of an extended 
review r would suffice to convey to the reader an abstract of the copious 
array of facts and arguments by which Dr. L. combats, and, as we con- 
ceive, overthrows, what has been of late a growing error in our country. 
We therefore abstain from any attempt at an analysis of the work, and 
urge all our readers, (especially all who live in fever districts,) to exam- 
ine it carefully for themselves. The question proposed by the author is 
the alledged identity, as to cause and character, of pneumonia and 
autumnal fever, but with this he has connected a full discussion of the 
whole wide topic of malaria and telluric exhalation. It has been custo- 
mary in certain quarters, of late, to throw doubt on the theory of Miasm r 
and to ascribe autumnal fevers to the same thermometric, barometric 
and hygrometric vicissitudes which produce pulmonary inflammation. 
The fallacy of this reasoning, Dr. L. exposes in a masterly manner. 
He demonstrates, to our entire satisfaction, the existence and morbific 
power of malaria, and shows that the circumstances engendering pneu- 
monia, are clearly distinct from those which occasion periodic fever. The 
history, given in this connection, of malaria as a cause of disease, is full 
and precise. We do not recall another book in our language in which 
the reader will find this topic as well treated. It should be in the hands 
of every physician who has fall fevers to manage. We sincerely trust that 
it may have a large circulation in the South and West, where its argu- 
ments and instructions are most needed. 

It is interesting, moreover, as being a truly original and American 
book, showing that we are competent to something more than the " edit~ 
ing" of English books, " with (or, as too often happens, without) notes- 
and additions." Dr. L. has long been known to a limited circle, as a gen- 
tleman of great learning and rather unusual powers of analysis, and bis 
name has not been entirely unknown to the general profession ; but this 
effort will secure for him a reputation as wide-spread as it is well founded 



1854.] Bibliographical Notices. 199 

&OM(EOPATHY Fairly Represented. A Reply to Prof. Simpson's 
" Hornceopaihy" Misrepresented. By Wm. Henderson, M. D., &c. 
Philadelphia, Lindsay and Blakiston, 1854, (8 vo. pp. 302.) 

There is no more wearisome task on earth, than the attempt to read a 
book written by a man in an ungovernable passion ; especially if the 
reader has no sympathy with the excited feeling of the author. 
Such have we found to be the case with the present volume, which 
purports to be an answer to the work of Dr. Simpson, noticed in our last. 
We confess that we have found it spiced beyond the tolerance of our pa- 
late, and have been obliged to lay it aside in disgust. The violent anger of 
the writer stands out upon the title page, roars in the preface, becomes 
hysterically shrill in the earlier chapters, and grows louder and more 
blatant to the end. We know very little of Dr. Henderson ; but we can- 
not consider him a very amiable person. If he ever was such, the "perse- 
cutions," which he alleges he has undergone for his faith's sake, have 
dismally soured his temper, and converted all the "milk of human kind- 
ness" in his composition, into the gall of bitterness. To Dr. S. he ap- 
plies numerous epithets, more expressive than nice; and he does not hesi- 
tate to attack grossly the social and moral, as well as professional stand- 
ing of any one whom that gentleman quotes, in confirmation of his views 
or assertions. In this way, our countryman, Dr. Horace Green, comes 
to be most unmercifully pilloried, and the same fate is met by the Ger- 
man gentlemen, mentioned in the extract, in our last number. Dr. H. 
is very fond of using ridicule, and it must be confessed, that his sarcasm 
displays no lack of bitterness, although deficient in the more genial ele- 
ments. Indeed, his laugh has something hyena-ish about it, which is 
anything but mirth-inspiring. Altogether, the manifestation of temper 
is bad, execrably bad, and the book is, in this respect, a disgrace to the 
literature of the day, being a striking contrast with the work to which it 
professes to reply, and which, however severe in its criticism, is always 
quiet in tone, and respectful in expression. 

Not having reviewed the argument of Dr. S., we will not, of course, 
enter into an examination of the attempted reply. We may remark, how- 
ever, that it is precisely what might be expected from its temper. Ar- 
guments are met with rant, and facts with angry declamation, and, when 
he can do no better, the writer raises the doleful cry of " persecution," 
and casts himself upon the sympathies of his readers, to take his suffer- 
ings in place of his reasonings. Some of his arguments are beneath con- 
tempt, and want even the infinitesimal amount of verisimilitude that 
might suffice for the homoeopathic mind. His attempt to bring sul- 
phate of quinia within the operation of the law of similia similibus, is 
all a contemptibly and transparently unfair taking advantage of the 
loose manner in which the word fever is used by medical writers, to sig- 
nify anything from a grave, specific, general disease down to a momenta- 
rily excited circulation. In his remarks on the "Itch Doctrine," he evi- 
dently thinks he has fairly tripped up his antagonist and enlarges accord- 
ingly. ' He first makes the violent assumption, that Hahnemann did not 
mean itch precisely by psora, but rather all cutaneous disease, because 



'200 Bibliographical Notices. [April, 

itch is only of late understood ; and then he goes hack to the humoral 
pathology of the last century, to show what morbific effects they then 
ascribed to the retention of excretions, especially the cutaneous. He thus 
demands that the great revelator of medical light to the nineteenth cen- 
tury, shall be tried by the scientific standard of the middle of the eigh- 
teenth ! But was the mighty seer exempt from the law and obligation 
of progress ? He lived, practiced, and taught many years after the mi- 
croscope had demonstrated the parasite in itch j and yet he always con- 
tinued to use the term as his followers still do. Unfortunately for them, 
their " system," like all others of the kind, is unalterable by its assump- 
tions, and therefore, to change is to die. But we have already given a 
greater space to Dr. H, than we intended. If, however, we thought he 
would heed us, we would still whisper a parting word of advice into his 
ear, suggesting a blue pill in the evening, and saline draught the next 
day, with milk diet and retirement from the field of controversy, until 
he has grown a milder temper and better manners. 

A Treatise on Venereal Diseases. By A. Vidal (de Casis.) 
With colored plates. Translated and edited By George C. Black- 
man, M. D,, &c. New York, S. S. & W. Wood, 1854. (8vo. pp. 499.) 

When we desire definite information in regard to the class of diseases 
treated in this volume, we naturally turn to the great centre of the civil- 
ization and vice of Christendom. The extensive Hopital du Midi, of 
Paris is, and will probably long continue to be one chief source of au- 
thority upon these affections. Its principal surgeons at present, are 
Messrs. Ricord and Vidal (de Cassis,) and to whatever comes from either 
of them, the greatest importance necessarily attaches. They differ from 
each other widely in regard to topics of primary interest, and each 
maintains his position with zeal and ability. Ricord' s popularity has 
been enormous and his authority overpowering. In this country, (more 
than elsewhere,) his word has been regarded as law. Yet observing men, 
and especially those who have made syphilis their particular study, have 
been more inclined to repose confidence in his quieter and less boastful 
colleague and rival, the author of the present volume, which is to our 
minds, more satisfactory than the more pretending work of Bicord. Every 
practitioner should have near him a text-book on venereal diseases. If 
they seldom present themselves, the more need has he for a ready au- 
thority to consult, or he may improperly treat them or lose invaluable 
time. For this purpose we do not know a better book than M. Vidal's, 
and we cheerfully recommend it to our readers. The translation is a good 
one, and the notes of Dr. Blackman add value to the work. 

$0° We have been obliged, for want of space, to postpone two or 
three book notices prepared for this number, to our next issue. 



1854.] Editorial. 201 



EDITORIAL. 



AN AMERICAN MEDICAL REVIEW. 

In noticing the report of Dr. N. S. Davis, on Medical Literature, at 
the meeting of the National Association, in New York, in our number 
for May last, we quoted particularly, his severe remarks upon the criti- 
cal department of our Journals. These remarks lose none of their se- 
verity, as we now read them at our leisure in the published proceedings; 
but we still must concede their general correctness, and approve their 
spirit. It is undeniable, that the critical standard of our best Journals 
is not high, compared with those of Europe. They seldom, if ever, pre- 
sent us with a Review worthy of the name. Dr. D. is right in saying 
that they rarely rise above a " book notice." We agree with him also, 
in deploring this state of things, as one discreditable to the great medi- 
cal body of our country, and calling for speedy reform. In any feasible 
plan for the elevation of this department of American Journalism we are 
prepared cordially to unite, and cheerfully to co-operate. Let us have a 
definite proposition to act upon, and we will help it forward with voice 
and pen, to the extent of our humble abilities. 

But let us first carefully see what we are about, and not confound to- 
gether things essentially distinct. The Critical Review has its peculiar 
and independent place in periodical literature, being generally regarded 
as its highest department. It belongs to the category of severer studies, 
rather than of light reading. It is not like the Journal, to be picked 
up for the entertainment of the vacant half hour, and then thrown aside, 
but requires careful and continuous perusal. It will not bear too fre- 
quent repetition. The quarterly form is that almost universally appro- 
ved. Never to our knowledge, has it flourished as a subordinate depart- 
ment of any other form of Journalism. The Journal proper, has its ap- 
propriate use in the frequent periodical report of medical intelligence, 
and short articles partaking of the "news" character; and the more 
Eclectic Magazines are serviceable by collecting such items of profes- 
sional information into a more concentrated form. In both these, how- 
ever, the extended review is out of place, and is invariably pronounced 
" heavy." From the very exigencies of the case, it changes its style 
and becomes what Dr. D. deprecates, a mere book-notice ! If, therefore, 



202 Editorial. [April, 

the profession desire a Review, we hold that they must support a publica- 
cion exclusively devoted to it. Will patronage be afforded ? There can- 
not be a doubt of it. Look at the liberal support given for years to the 
re-publication of the Medico-Chirurgical Review. How then shall it be 
originated ? Some have suggested that it should be published by (or be 
in some way under the control of), the National Association. We confess 
that we can see strong objections to this plan, from the outset, but it 
will be fairer to wait for details before urging them. Shall it be left to 
individual enterprize? Here are difficulties again. We may have to 
wait indefinitely for our Review, and when started, it will probably be 
by some of the great publishing houses, whose books are to be the sub- 
jects of its critical animadversions ! Plainly, that will not answer. 
Whichever way we turn, there is difficulty, and the whole subject there- 
fore deserves a deliberate and thoughtful discussion. We trust that it 
may come up at the next meeting of the National Association, and that 
some action may be had. It is not likely to be allowed to sleep, now 
that Dr. Davis has taken it in hand. He is not the man, as his connec- 
tion with the early history of the Association shows, to turn back after 
he has once put his hand to the plough. We wish him success, and tender 
him all the little assistance we can afford him. 

In the meantime, we must take issue with him in regard to his implied 
(rather than distinctly expressed,) sweeping censure of the book-notices of 
our Journals. As far as these are mere rt bookseller' s puffs," they of 
course, deserve the worst Dr. D. or any body else may say of them. This 
abuse arises from a circumstrnce before referred to — i. e. that the Jour- 
nals in question are the property of wealthy book-publishing houses, who 
regard them mainly as advertising media. But this abuse of a thing 
does not argue against its proper use. - The book-notice is an integral, 
and always interesting portion of the Journal, and is entirely different 
in object and method, from the Review. The latter concerns topics ra- 
ther than particular books. Thus, the simultaneous appearance of two 
or more works on chronic uterine diseases, might suggest an extended 
and philosophical examination of the entire topic, in which the said 
books would be examined, compared, and estimated. The subject being 
thus exhausted, would not accumulate interest again for another such 
examination, under several years, or, if it did, could not claim space in 
the same Review, without undue exclusion of other important matter. 
But new books on the subject appear from time to time. New editions 
show sometimes, altered views, sometimes new facts or therapeutic pro- 
cesses of value. Are these to be passed in profound silence, because un- 



1854.] Editorial 203 

worthy to aspire to the solemn dignity of a regular review ? It is to such 
cases that the Bibliographical Notice is precisely adapted. Its object is 
to announce to the profession the appearance of every new book, with 
some slight indications of its scope and character. That such notices are 
almost always commendatory, may be evidence of the general merit of 
our medical literature, or it may merely prove the great good nature of 
the critics. We plead guilty to being commendatory wherever we justly 
can be so, and we confess that our object is, in one important respect, 
identical with that of the compilers of u booksellers' puffs." Our com- 
mon intention is to induce our readers to buy books — they, with a sole 
view to the pecuniary interest — we, because, we desire to see a library 
in every Doctor's office. One of our earliest professional recollections is 
of a country Doctor's office we once visited, where the impressions left 
on our mind, were of a lot of extremely dirty drawers ; a number of un- 
labeled bottles, whose contents were invisible from external incrusta- 
tion; a very bad smell ; some snakes in a glass jar of spirits, and a torn 
copy of Coxe's Dispensatory — the latter being its sole literary treasure ! 
And yet the proprietor of this den, (personally a most estimable man,) 
passed for an intelligent regular practitioner ! We cheerfully admit that 
a case of this kind has become almost impossible in our day ; but, in 
making the admission, we claim the credit of the change, in great de- 
gree, for this very department of "Notices/' which has stimulated and 
kept alive the demand for new books and the love of reading. 



AMERICAN MEDICAL ASSOCIATION. 

As the spring opens upon us, and its fresh verdure peeps out from 
the cold bed in which it has lain for so many months, we can but re- 
member again the annual coming forth of the American Medical Associ- 
ation. The radicles that have eminated from its centre, penetrated the 
deep soil of the profession, and now lie embedded in the various medical 
organizations of the nation, are being revived by the salutary action of the 
faithful guardians of her interests, and the budding has already com- 
menced, that indicates a fruitful harvest, to be gathered in the far-off 
West. We are glad that St. Louis has been selected, as the next place 
of meeting. The West deserves to call in the forces of the profession to 
her own bosom, and we are assured, that a hearty welcome will not only 
be given to distant members, but a stimulus imparted to the medical zeal 
and energy of the great valley, and of all the region from the Delta, to 
the virgin lakes that lie at its source, that we trust may be felt in the 



204 Editorial. [April, 1854.] 

general improvement of medical science. We would urge upon local socie- 
ties in our State, to send on the names of their delegates, to Dr. E. S. 
Lemoine, of St. Louis, who will register them, and provide for their ac- 
commodation. 

Dr. Lemoine, one of the Secretaries of the Association at St. Louis, 
writes us — "Our various committees are actively engaged, preparing for 
the reception and entertainment of a large delegation ; and we hope to 
have the pleasure of welcoming the representatives of every medical body 
in the Union. Lists of delegates are coming in from all directions, 
and we have the prospect of a large attendance." 

We will not occupy space in anticipating the action of thq Association, 
upon subjects, about which we have spoken freely before — but we felt 
bound to remind our friends of the Meeting. 

For the past three years, we have furnished our readers with early, 
and full reports of the proceedings of the Association, and this year, we 
are making arrangements, through the courtes}^ of Dr. Lemoine, for a 
special report of the proceedings at St. Louis, for our pages. 

J. P. 



Articles on the American Medical Association. — We present our 
readers this month with number three of this interesting series of pa- 
pers, comprising the history of the Association for 1847. These articles 
which are increasingly interesting, are attracting the attention of the pro- 
fession, and we trust they will exert an influence for good. 

We are assured by the engraver, that the Portrait of Dr. A. H. Ste- 
vens will be ready for our May number. The biography and Portrait 
of the late Dr. Chapman, will be issued in the form of a supplement to 
the Reporter, as soon as the former is ready. 

Portraits of Drs. J. C. Warren, of Boston, R. D. Muzzey of Cincin- 
nati, and the other Presidents of the Association will follow in their 
order. 



J8^° A variety of Editorial and other matter, is excluded for want of 
space. 



Notice. — Correspondents, who wish to address Dr. Parrish,- will 
please direct their communications to the N. W. Corner of Arch and 
Seventh Streets, Philadelphia. 



THE 

MW JERSEY MEDICAL REPORTER. 

VOL. VII. MAY, 185 4. NO. V. 

" The Change of Life," in Women ; with remarks on the periods 

usually called " Critical." 

By Joseph Parrish, M. D. 

NUMBER IV. 

Sympathy between Brain and Items; — Items matures early — mind does not. 
Women should welcome the "Change •,"— Illustration of Speculum Specialty. — 
Injury to the morale of the Sex. 

We have said that the time comes in the history of woman, when the 
mind acts with mature vigor, and the generative organs decline. This 
sentiment is predicated on the fact, (or, if preferred,) the assumption, 
that there is a striking sympathy between the mind and the womb, 
though each may perform its functions with entire independence. 
They do not begin in early life, to exhibit their powers at the same 
time, and yet go on for the score and a half of years allotted to uterine 
activity, in near relation to each other. When the uterus ceases to draw 
upon the nervous energy for support, the mind, strong in years, and 
mature in knowledge, goes on to the more perfect development of its 
powers, till, in old age, the brightest gem in the circle that adorns its 
venerable crown, is wisdom. The uterus matures early, — the mind does 
not. One is destined to a short existence. The other, to an immortal 
life. True, as in second childhood, or in the condition usually known 
as the period of dotage, there may be a perceptible failing of mental 
power. The vigor of earlier days may pass away, and a sad imbecility, 
hang like a pall, upon the darkened pathway of the aged matron. But 
even in cases of this kind, it is a question, whether the power of the 
mind to live, and enjoy, and even to progress, is lost. In the multitude 
of infirmities, that crowd about the human form, and crush it to the 
earth, the mind may be buried in the wreck ; but it is a good 
thought to think, that it is only buried from sight — that it assumes na- 
27 



205 . Original Communications. [May, 

tive life again, in its native clime — and that it may go on from one state 
of perfection to another, in accordance with its unending destiny. 

As the uterus matures early, so it dies early : for when it ceases to 
act, it begins to die. After its allotted time, it may never be renovated 
again. This is not an accident, but a law — not a misfortune, but a 
blessing. And yet, the ever active mind dwells upon it, thinks it over, 
and imagines evil. It anticipates trouble, and sorrow, before it realizes 
them. The u critical time" comes. The subject of it has passed through 
the varied changes, incident to a state of virginity, and fruitful woman- 
hood, and now occupies a stand-point, hitherto unexperienced. She looks 
back, counts her many escapes from danger, her wonderful recoveries 
from serious disease perhaps, numbers her growing flock, and feels a 
just and lofty pride, that she has filled her place in the social, and do- 
mestic relations of life. She casts too, a timid glance, into the perspec- 
tive that lies before her, and as she sees it gradually narrowing to a point, 
it may be in her view, distant or otherwise, she is too apt to anticipate a 
gloomy pilgrimage, over the untried pathway that lies before her. For 
the first time in her history, the flow that has hitherto returned at regu- 
lar intervals, ceases, without the intervention of pregnancy, or any 
known cause, over which she has control; and for this reason alone, she 
startles, and doubts. And while she may be strong with many days, 
and wise, with much experience, it is no marvel, that as she stands upon 
the narrow line, which divides her life, she looks upon either side, — to 
the past and the future, with conflicting emotions, such as no one can 
faithfully describe, but herself. It is difficult for her to realize, that for 
this cessation there is a natural cause, as there was a cause for the first 
appearance of the menses, or for their occasional interruption. And as 
her mind wanders away to the fields of fancy, she broods over unreal 
evils, and becomes the victim of actual disease. I would not be under- 
stood to assert, that the afflictions often noticed at this period, are inva- 
riably the result of a morbid mental condition — far from it ) — but that 
there are often reasons for seeking medical counsel, that have their origin 
solely in groundless mental apprehension. If it be true, that there is a 
perversion of feeling, and temper, when the menses are arrested by 
pregnancy, may it not be true, that when they cease to flow, at all, we 
may witness other equally singular exhibitions of mental and moral 
feeling f 

It is a curious fact, that in cases, where the menses are arrested by 
disease, the moral and mental phenomena are not perverted, as they are, 
when a natural cause interrupts their regular appearance. It is true, the 



.85-4.] Faurisii— Change of Life in Women, 207 

>rain, may be oppressed, and the countenance dejected; s and there may 
>e pain, or a sense of weight or fullness in the head, perhaps. And 
rhile all these symptoms, indicate a near sympathetic relation between 
he brain and the uterus, they present a modification which strikingly 
adicates the line, between organic disease or disturbance, and the ner-: 
ous, or as we have already called it, the telegraphic power which main- 
lins a relation, or intercouse between the two. 

In amenorrhea for example, depending upon an atonic state of the 
pstem, or, perhaps the result of cold, or other accident, we see neither 
].e morbid taste, which is exhibited in pregnancy, for strange and dis- 
usting food, or none of the exquisite apprehensions, which are constant- 
r agitating the mind of the matron, as she approaches the last " critical 
9riod," peculiar to her sex. It will not be denied, we think, by any 
le of experience, who has closely observed the psychical expressions 
i the female under the various manifestations of uterine disturbance, 
hether natural, or morbid, that the brain maintains a nearer sympa- 
tetic relation with the generative system than any other organ of the 
)dy, with perhaps the exception of the stomach, which also participates 
rgely in the disturbances induced through the nervous system. If it 
sre not so, we might reasonably expect to find engorgment of the liver, 

well as of the brain, in the event of a suppression of the catamenia. 
r e should expect our patients to refer to the hypochondriac region, as often 

to the cerebral, as the seat of uneasiness. And we see no reason why 
e contiguity of the bladder, the kidneys or the bowels, might not ren- 
t them as liable to take on sympathetic action, if it was not that the 
ain was ordained the guardian of that particular system of organs 
lich refers to the production of intelligent beings. We must be care- 
l not to lose sight, at this juncture, of the fact, that since the womb 
.s been an active organ, the mind perhaps, was never more capable of 
erting its powers; and that the womb, was never less so. Now, it may i 
jm strange to dwell upon this fact — and yet, it is considered one of 
portance, and is presented here, thus prominently to secure the atten- 
n of the reader to the idea offered in essay, No. 1., to wit : that "wo- 
rn should learn to ivelcome, rather than to fear this change," and that 
is the office of the physician at such a period, "not to alarm, but to 
:ourage, and support" his patient. To welcome the cessation of a na- 
*al, periodical, and healthy discharge, may seem difficult. To be- 
ve, that from a certain time of life, it would be unnatural, and unheal- 
Y, for it to continue, after at least thirty years of regular recurrence, 
y seem difficult. That such an entire, and positive revolution should 



208 Original Communications. [May, 

occur in the female constitution, without leaving traces of disease, and 
causing suffering may also seem difficult to realize. But the mind must 
be disciplined into the service ; the woman must rise above her appre- 
hensions, and the thoughtful physician hold up her hands, and give her 
a cheerful onward bidding. 

The experience of the writer, with this class of patients, has not been 
inconsiderable. It has been his privilege to attend many females of 
strong and cultivated intelligence, safely through this period, by the 
simple expedient here referred to — keeping the mind, as it were, above 
the womb, — the thoughts above disease, — the hopes beyond danger, and 
it has been his happy lot to see many cross the line, without apprehen- 
sion, and hence without suffering. True, if there is disease in the sys- 
tem, lurking there, in anticipation of laying hold of a debilitated, inner- 
vated organ, upon which to expend its ravages, no mental effort can re- 
strain its power. This we have often seen, and perhaps no physician 
has ever watched over the last days of a patient, writhing in the pains 
of cancer of the womb, and forgotten the hours of suffering, in which his 
skill has failed to alleviate, and his sympathy been unable to soothe. 
But we have to do with the thousand and one ailments, that are the re- 
sult of morbid fear, or groundless apprehension, and which it is asserted 
may be prevented, by bringing to bear the mental powers of the individ- 
ual herself. 

The brain, the guardian of the uterus. The strong, the pro- 
tector of the feeble. This is the idea. Suppose the strong, to be un- 
trained. Let it be the generator, and the cultivator, of false, and imagi- 
nary ideas, and those ideas, be they persistent or fugitive, durable or 
transient, will, just in proportion as they refer to, and operate upon the 
enfeebled, and dependent organ, carry the latter in their own morbid 
train. Apprehensions will grow into realities perhaps, fears become the 
ruling power, and the unfortunate patient, the slave of that power. 

Let us present a case. A lady offers herself for treatment. For a few 
months she has menstruated irregularly. Sometimes the discharge has 
been abundant, and sometimes scanty. Once or twice, perhaps, clotted 
blood has passed the vagaina, and then again it has been deficient. She 
has had pain in the back, and loins, at some of her periods, and been 
free from it at others. The prescriber enquires about her previous habits 
of life, and finds that she has borne children, and has had no more than 
she could have expected of the common ills, and sufferings of life. " He 
finds that she is on the shady side of forty, and if he be a man who is 
moved by sinister motives, dishonest, and extortionate, who makes a 






L854.] Parrish — Change of Life in Women. 209 

trade of his profession, and boasts of his success, he begins after this 
prise. " You are approaching the critical time of life. Your womb is ex- 
tremely irritable ; it is very feeble, and you are liable to sudden, and 
dangerous hemorrhage. If you do not allow me to prescribe for you re- 
gularly till you pass this fearful crisis, I cannot be responsible for the 
issue. All this clotted blood probably comes from some organic change 
n the structure of the uterus. It may be the commencement of a can- 
3er, which I can arrest by caustic, or possibly there is a polypus, or 
some more dangerous foreign body in your womb, which will require to 
be extirpated." An hour is appointed for a visit ; the speculum and the 
Ireaded case of instruments, with all the paraphernalia incident to this 
species of quackery, are displayed. The womb is exposed to view. Females, 
who have never before seen the organ, are now quietly indulged with a 
sight, and erudite explanations whispered into their ears, and then their , 
testimony secured to sustain the opinion of the animal who conducts the 
examination, that it is a " dreadful sight to behold." Syringes are now 
brought forth, and dexterously used ; and then, appliances of various 
kinds recommended, none of which, perhaps will do harm, or good, and 
n the course of nature, the discharge soon ceases. The patient is free 
from her apprehensions, and goes from neighbor to neighbor, to laud 
the skill of the being who has miraculously saved her from death, while 
he appropriates a large fee to the feeding of his self-satisfaction, and false 
dignity. 

Such is the road to fortune. Who will follow it? Many have. 
Cases of this kind have frequently come under the observation of the 
writer. But how much more judicious to say to a patient under these 
circumstances — "This is the time of life to expect a change. You could 
not menstruate much longer without danger, because it would be un- 
natural. Nature is very kind; she wishes you to be healthy, and happy 
during the remainder of your days, and you cannot be, without this 
monthly flow ceases. If the discharge is at any time excessive, rest on 
your bed, or couch, till it moderates. Take your ordinary food regularly, 
ind as bountifully as is your habit, being careful not to offend your diges- 
tive system, or allow the regular action of your bowels to be interrupted. 

If you feel any more unpleasant symptoms, consult your physician; 
but as an intelligent woman, remember that this change is for your good, 
and do not allow meddling nurses, or officious doctors, to convince you 
to the contrary; 'for the truth is not in them/ unless it may be more 
charitably said, that their ignorance has called them out on a truant 



210 Original Communications. [May, 

errand, arid made them fit subjects for the wise injunction, * Beware of 
presumptuous sins.' y} 

The speculum practice, per se is unobjectionable, but the speculum 
specialty, as at present used, is a monster in the profession. A delicate, 
sensitive female, laid upon her back, her knees drawn up, and a valvular, 
or conical, or any other kind of tube, passed to the full extent of her 
vagina, with the light of a candle, or the direct rays of the sun, brought 
to bear upon the tube, and concentered in a focus, upon her womb, is an 
outrage upon her sex, and an indignity to the medical profession, unless 
in cases, rendering it absolutely necessary. The mental and moral shock, 
alone produced by such a course, particularly in a young, unmarried fe- 
male, is sufficient to produce a train of symptoms, that may demand pro- 
fessional interference — and it has been often a question, whether the in- 
jury done to the morale of tlie sex, by such a system, has not greatly 
overbalanced the physical advantages, resulting from the unwarranted 
use of the instrument. 

Philadelphia, April, 1854. 

TO BE CONTINUED. 



Cases of Singultus. By William Johnson, M. D. 

Singultus, often a mortal, is always to the adult, a most painful and 
distressing affection. When it occurs as the sequel of acute disease, its 
significance is important, and often boding disastrous issue. The re- 
cognized causes of this disease are various, such as predominant acidity, 
or alkalescency of the contents of the stomach ; excessive repletion of 
this organ; crude and indigestible substances floating at the upper orifice; 
lesions of the stomach ; simple spasmodic action and sympathy with a 
perishing organ. It is but seldom that the idiopathic form of this dis- 
ease comes under the treatment of the physician ; in general it readily 
yields to domestic appliances, and among these a lump of loaf sugar 
cures it, tuto, cito etjucunde. But it is not always that this disease 
even when primary and idiopathic, is so easily subdued ; it is sometimes 
exceedingly persistent and runs on for weeks. I was once consulted by 
an aged man who had labored under this affection for two weeks, and 
cases are recorded where it has run on for nine or ten weeks. The bulk 
of the cases of idiopathic singultus in which I have been consulted, have 
occurred in the aged. The celebrated Dupuytren, however, relates a 
case of this form of singultus, which occurred in a female aged thirty- 
two years, of a very susceptible habit. The hiccups were so very dis- 



/ 

1854.] Johnson— Cases of Singultus, 211 

tressing, that he thought himself justifiable in resorting to the actual 
cautery for their removal. A red hot iron of an oval shape, and an inch 
in diameter, was applied to the xiphoid cartilage, until the part was red- 
dened; the skin only was destroyed, and after several applications, the 
hiccups were permanently cured. In another patient he found it neces- 
sary to resort to the same measure. 

From the etiology of this disease, it will be seen at a single glance, 
that the treatment must be variant, and that much will depend on the 
sagacity and judgment of the practitioner for its removal. I dismiss, 
however, this part of the subject,, as it was not my object to write an 
essay, but merely to relate a couple of cases of the symptomatic affec- 
tion, which, to my mind, possess much interest. 

Case 1. — W. J. aged about 45, some years since, was at the close of 
an attack of hepatitis seized with singultus in its most distressing form. 
The condition of the patient at this time, was the most unpromising. 
His prostration was great — his body was attenuated by disease — his skin 
and adnata of his eyes was of the deepest icterous tinge — there was 
febrile movement — the convulsive action of the stomach and diaphragm, 
resulting from singultus, was so great as to shake the bed on which he 
lay, and could be distinctly heard in an adjacent apartment. It struck 
me at the commencement of this attack, that my patient's hiccup was 
simply spasmodic, and that the tinct. assafoetida was the very article in- 
dicated. I proposed it to him, and urged its importance. He objected 
in the strongest terms to taking it, stating that no article was so horrid- 
ly offensive to him as the assafoetida. Other articles were substituted, 
but they did not answer. Among the rest musk was freely given. It 
would, however, be tedious and unprofitable to enumerate the various 
medication which was employed, under the united counsel of myself and 
the late Dr. Isaac Ogden, of New Germantown, who attended the case 
daily with me. The singultus was almost constantly present, day and 
night, for about 8 or 9 days. My patient having now experienced the 
utter inutility of all that had been done for him, consented to take the 
assafoetida. The tincture, in doses of 40 drops, was administered every 
three or four hours. Almost with the first dose there was a decided 
mitigation of the hiccups. The assafoetida was used two or three days, 
when it was discontinued. No return of the spasmodic affection occur- 
red. The patient recovered from this attack. 

Case 2. — E. R. J. aged 50, a very near and dear relative of mine, at 
the close of severe pleuritis, was seized with singultus, and for four days 
nothing in the form of food, drink, or medicine, passed the cardiac ori- 
fice of the stomach, without exciting this painful spasmodic action of the 



V 

'212 Original Communications. [May, 

stomach and diaphragm. Her sufferings were so great from ingesta into 
the stomach/ that she told me that she would rather do without drink or 
food, than suffer so much torture. As soon as any article entered the 
cardia, a " boring sensation" was produced, and singultus immediately 
commenced. The spasmodic action was continued for a considerable 
length of time, with the greatest distress to her. Day and night, this 
dreadful hiccup sounded in my ears the knell of departing hope. At 
the commencement of this attack I proposed to her vinegar, as a remedy 
which I thought was adapted to her case, and one that promised to be of 
much utility. I stated to her that I had prescribed it in doses of a tea- 
spoonful, four or five times a day to an aged man (a case previously al- 
luded to) who had had the disease a fortnight, and that he was relieved 
almost immediately by it. She objected as strongly to taking it as did 
my other patient to the assafcetida. Although she was in the habit of 
using vinegar as a condiment, and was fond of it, she now objected in 
the strongest manner to its use, stating that it would so " sour her sto- 
mach that she could not bring herself to take it." It would be useless 
to enumerate the various articles of the materia medica which I prescri- 
bed in her case j none afforded her the slightest relief — even the appli- 
cation of a large epispastic over the stomach. At the end of the fourth 
day I urged again the vinegar even in very small doses. She now con- 
sented to take it. One large sized tea spoonful of vinegar of a very su- 
perior quality, was added to five tea spoonsful of water, and the medi- 
cine directed to be taken pro re nata. The first dose had a remarkably 
soothino- effect upon the stomach, and was the only article that for the 
last four days, had not produced most distressing singultus. The spas- 
modic affection yielded from that hour, and before she had taken three 
tea spoonsful of the vinegar, she was cured. She made a good recovery 
to accustomed health. 

Remarks. I have seldom witnessed more unmistakable evidence of 
remedial efficiency than was manifested in these two cases. From the 
first dose of the appropriate remedies, decided improvement took place. 
I have thought the cases worthy of being recorded. It sometimes hap- 
pens that in the treatment of a case, we have exhausted our resources 
and would gladly accept a nail to hang a hope upon. To meet such a 
contingency, I have drawn up the foregoing cases, and present them to 
my medical brethren. They are among the many reminiscences of _ me- 
dical life to which my mind reverts with gratitude to the Giver of all 
good, for the signal manner with which He has blessed my humble ef- 
forts for the relief of suffering humanity. 

White House, April, 1854. 



L854.] Proceedings of Medical Societies. 213 



PROCEEDINGS OF MEDICAL SOCIETIES. 



District Medical Society for the County of Burlington. — The stated 
quarterly meeting of this Society was held at Mount Holly, on Tues- 
lay, April 11. In the absence of the President, Vice President and 
Secretary, Dr. Stratton was called to the Chair, and Dr. Elwell appointed 
Secretary. 

The minutes of the last meeting were read and adopted, when Dr. 
Read, who was appointed at the last meeting to open the discussion on 
Puerperal fever, read an essay on the subject, which gave evidence of 
much patient research, and an intimate practical knowledge of the 
lisease, as well as of the opinions of medical writers. The thanks of the 
Society were voted to Dr. Read for his able essay, which was laid upon 
;he table for discussion. This was carried on profitably, and with good 
'eeling, and was participated in by several members. The subject was 
aid over for consideration at the next meeting. 

Drs. S. C. Thornton, Jr., G-eo. Groodell, and E. R. Denby who were 
)roposed for membership at the last meeting, were unanimously elected, 
md Drs, Tracy E. Waller of Columbus, J. Howard Pugh, of Burling- 
ion, Lewis Baily of Lumberton, and E. B. Woolston of Vincentown, 
vere proposed for membership. 

Dr. Budd, at the request of the Society, made some statements con- 
jerning a very fatal epidemic of a congestive character, which has re- 
entry prevailed in Medford and vicinity, and was requested to draw up 
m account of it, to be read at the next meeting of the Society. 

On motion, Drs. Spencer of 'Moorestown, and Butler of Burlington 
vere appointed delegates to the meeting of the American Medical As- 
lociation at St. Louis, on the 2d of May next. 

Members present— Drs. Stratton, Read, Spencer, Woolston, Reid, 
Budd, Martin, Butler, and Elwell. Individuals not members— Drs. 
3 ugh, Waller, E. B. Woolston and Mr. Jennings, (student) of Mana- 
lawkin. 

Society adjourned to meet at the house of R. C. Humphrey, Mount 
lolly, on the second Tuesday, (11th) of July next. 

A. ELWELL. ti& ~ - ' 
28 



214 Original Communications. [May, 

District Medical Society for the County of Cumberland. — At the 
Annual Meeting of this Society, the following officers were elected for 
the ensuing year : 

Dr. Ludlam, President; 

E. E. Bateman, Vice-President; 

J. B. Potter, Secretary; 

B. R. Bateman, Treasurer. 

The committee on medicine, medical men, &c, in the county, Report- 
ed, that they had made considerable progress in the collection of mate- 
rial, hut in the hope of obtaining additional matter, they thought it de- 
sirable to defer the final report until next meeting. 

Dr. Buck made statements in regard to the manner in which the com- 
mittee had been employed \ of the difficulty of collecting materials from 
such various and scattered sources ; and that the work had been growing 
on their hands \ accompanied with a request that the committee be con- 
tinued. 

Dr. Newkirk, the Chairman of the committee on the relation of me- 
dical men to quacks and quackery, made an able report on that subject. 

The calling of the roll for epidemics, exhibited the usual catarrhal 
affections during the winter, accompanied, in Bridgeton, with unusual 
tendency to the throat, ear, and Schneiderian membrane. 

In Fairfield, hooping cough prevailed, and in some cases was mingled 
with the anginose affection. In these instances the hooping sound was 
not distinguishable from the ordinary pertussis, but subsided in four or 
five days. 

Fifteen well marked cases of Scarlatina occurred in the neighborhood 
of Shiloh, two of which proved fatal. Only a few sporadic cases oc- 
curred in other parts of the county. 

After dinner, the Society convened, and Dr. Tomlinson read the Re- 
port of the Delegates to the New Jersey State Medical Society. 

Dr. Parker delivered an address upon u the prospects of the Medical 
Profession in the United States." 

Drs. E. Fithian and W. Elmer, were elected delegates to the Ameri- 
can Medical Association, and Dr. Newkirk was appointed Reporter for 
the following year. 

Present at this meeting, Drs. Bowen, Buck, Eph. Bateman, Sheppard, 

B. R. Bateman, Newkirk, E. E. Bateman, Elmer, Ludlam, Hampton, 

Tomlinson, Parker and Potter. 

J. B. P., Sec'y. 



1854. J Bibliographical Notices. 215 



BIBLIOGRAPHICAL NOTICES. 



Transactions of the Medical Society of the State of Pennsylvania at its 
Annual Session, held in the City of Philadelphia, May, 1853. Pub- 
lished by order of the Society. Philadelphia : T. K. & P. Gr. Collins, 
Printers, pp. 126. 

Transactions of the Medical Association of Southern Central New York, 
at the Seventh Annual Meeting, held at Ithaca, June, 1853. Auburn : 
Printed for the Association, by Wm. L. Moses, pp. 96. 

Although the works, whose titles we give above, have been some 
time before the public, we cannot forbear a notice of them, inasmuch as 
such notice falls in with a general plan we have marked out, and as they 
contain much that is valuable, which in the form in which they are pub- 
lished, necessarily has a limited circulation. The works might have been 
noticed earlier, but for the fact that they have only recently come into 
our hands, and in consequence of the overcrowded state of our columns 
since they reached us. We hope our friends, the Secretaries of Me- 
dical Societies, will do us the favor to forward copies of their transac- 
tions, as promptly as possible, that we may notice them for the mutual 
benefit of their Societies, our readers, and the cause of medical science. 

The Medical Society of the State of Pennsylvania met at Sansom 
street Hall, Philadelphia, on Wednesday, May 25th, 1853, and contin- 
ued in session three days. The Society was called to order by the Pre- 
sident, Dr. Hiram Corson, when Delegates to the number of eighty-seven 
were received from fourteen counties. Dr. John P. Hiester of Berks 
County, was elected President for the ensuing year, and Drs. H. S. 
Patterson, and I. R. Walker, recording Secretaries. 

The perusal of the address of the retiring president, Dr. Corson, has 
afforded us much gratification. It is necessarily somewhat desultory in 
its character, for to use Dr. C's. own words, the object of an annual ad- 
dress, appears to be " to furnish to the president, who is not expected 
to participate in the discussions, an opportunity to express his thoughts 
on those subjects likely to occupy the attention of the Society, or which 
may seem to him, appropriate topics for consideration." The whole ad- 
dress is worthy the known character and standing of its eminent au- 
thor, and among our selected articles will be found a lengthy quotation 



216 Bibliographical Notices. [May, 

from it, on the use of alcohol in medicine — a subject which has been a 
good deal discussed in the journals of late, but on which we have, as 
yet, said little. We commend his eloquent remarks to the candid con- 
sideration of our readers. The volume is principally taken up with re- 
ports from the county societies, most of which reflect credit on their au- 
thors. The Committee of the Montgomery County Medical Society, 
have the following very sensible remarks on the subject of Reports — 

""We do know, that as reports are, not unfrequently, prepared, they are a mere dull, 
dry detail of ordinary diseases, characterized by well-known symptoms, which were 
treated by the ordinary routine methods of the profession, and followed by the usual 
results. As statistical facts, such reports may not be devoid of utility; but then for 
such purposes they are generally not stated with sufficient conciseness for ready use, 
and serve only to swell the already cumbersome mass of medical writings. As also 
confirmatory of well-known facts, such reports may be to a certain extent satisfactory ; 
but we must confess that we cannot see the advantage — whilst the disadvantages are 
so numerous as not to require mentioning — of occupying many pages merely to de- 
scribe the symptoms, etiology, treatment, and progress of a certain disease, only to ar- 
rive, in the end, at conclusions long since well settled. In such instances, the facts 
might be affirmed in a few words. 

" If, however, on the contrary, our observations should lead us to conclusions differ- 
ent from those generally known to the profession, or to something entirely new, then, 
and then only, can we see the advantage of giving all the facts, and the reasoning upon 
them, so that the medical community at large may see the manner in which certain 
deductions have been arrived at." 

From the reports, we gather that there was a general immunity from 
specific diseases in the counties represented, and that the few epidemics 
which did prevail, were mild in their character. Nearly all the re- 
ports give testimony as to the general prevalence of the "furunculoid 
epidemic," and the typhoid type that almost all diseases have tended to 
of late years. The most prevalent diseases seem to have been small-pox, 
scarlatina, measles, typhoid fever, the various types of intermittent dis- 
ease, erysipelas and furunculoid affections. In an admirable paper by J. 
M. Gemmill, M. D., of Alexandria, Huntingdon Co., "On Vaccination, 
Small-Pox , and Varioloid" from the detail of a large number of cases, 
Dr. Gr. draws the following inferences — 

" First. "We may have the vaccine virus, and the smallpox poison, in the same 
scab; hence, the necessity of extreme caution as to the sources whence we obtain 
our virus for vaccination. 

" Second. They show the antidotal power of the vaccine virus, as to smallpox 
poison. Hence, the importance of universal vaccination. 

" Third. They go to show that lapse of time lessens the protective influence of vac- 
cination ; not so much, however, the length of time, as the period of life at which the 
lapse takes place. It would seem that, from infancy to puberty, the protection is lost 
in proportion to the lapse of time ; as in all the cases of varioloid that occurred in~per- 



1854.] Bibliographical Notices. 217 

sons under the puberic age, the severity of the attack was proportioned to the age of 
the patient. 

" Fourth. They would favor the opinion that, during the changes which take place 
in the system at the age of puberty, a larger, porlion of the protection afforded by vac- 
cination is lost than during the same length of time at any other period of life. Hence, 
I would infer the importance of universal revaccination after that period is passed. 

" Although the facts detailed do not bear so particularly on the point, yet I may re- 
mark, that, in my experience, I have never met with a case of smallpox or varioloid, 
at any time of life, in a person who had been very recently vaccinated. Nor have I 
ever met with any such case in after life in a person vaccinated, or revaccinated, after 
having arrived at maturity. I have always found it afford certain and complete pro- 
tection in all such cases. In my own case, it is twenty-five years since I was revac- 
cinated, and ever since that time, I have been every few years exposed to the small- 
pox contagion, frequently in its most concentrated form, without ever having suffered 
in the slightest degree from its effects. 

"These cases show the great difference which exists as to the degree of susceptibi- 
lity to the influence of smallpox poison amongst different persons. Out of thirty-one 
persons vaccinated, on two successive days, with the same virus, but eight had vario- 
la in anything like a regular form ; eleven had the irregular sore arm ; and in twelve 
no apparent effect was produced. This would seem to indicate, that a wide margin 
should be left for exceptions, in any general rules that may be laid down as to the 
real amount of protection afforded by vaccination. And we might reasonably suppose, 
that persons who are so peculiarly susceptible to the influence of the Variolous conta- 
gion, would much more readily lose a portion of the protection afforded by vaccina- 
tion." • 

The Scarlet Fever that prevailed was generally of a mild type. Dr. 

Carpenter, (Report from Schuylkill Co.) and Dr. F. B. Poley, (Report 

from Montgomery Co.) speak very favorably of inunction as an adjuvant 

in the treatment of this disease. The latter says, 

" I have frequently seen the great heat of the skin, the itching, and the restlessness 
of the patient, subdued, as if by magic, by rubbing the whole surface of the body with 
warmed bacon. To get the full benefit of this remedy, the patient must be well greased^ 
and if the symptoms return, it must be repeated ad libitum." 

Dr. Carpenter says, — 

" My chief dependence in this disease, as an internal remedy, is on the solution of 
chlorate of potassa, and hydrochloric acid, as a drink. I have never seen so much 
benefit from any medicine, as from this. The dry brown tongue, and foul ulcers, and 
offensive breath, and horrible alvine discharges, are all corrected, with a certainty and 
celerity that are remarkable. Since I have used this remedy, with inunction, I have 
not lost a case of scarlet fever, and I have had many and severe cases to treat." 

In Erysipelas one report speaks highly of the tincture of the chloride 

of Iron, used in the manner, we presume, recommended by Mr. Gr. H. 

Bell, which is as follows : 

"If the erysipelas be mild, fifteen drops of the muriated tincture of iron are adminis- 
tered in water every two hours, untill the disease is completely removed. When the 
attack threatens to be more severe, the dose is increased to twenty five drops every 
two hours, and persevered in night and day, however high the fever and delirium." 



218 Bibliographical Notices. [May, 

The reporters seem to be almost united in regard to the specific cha- 
racter of Typhoid Fever. Dr. Gieger (Report from Montgomery Co.) 
says. 

"Typhoid fever is, in my opinion, a self-limited disease. Tt will run its course, which 
is about twenty days' duration, in spite of all treatment — unless the violence of the 
disease, or, what is, more frequently the case, the violence of the treatment cuts it 
short, and the life of the patient at the same time, before the expiration of this period. 
I look upon it as running a course almost as definite as smallpox, measles, or scarla- 
tina, and that like those diseases, it finally terminates by eliminating some morbific 
poison from the blood, the nature of which, in our present state of knowledge, is en- 
tirely unknown to us." 

The same unity of opinion prevails in regard to the expectant mode of 
treatment. Bloodletting, and alcoholic stimulants are both pointedly 
condemned by most of the reporters. One writer recommends the use 
of diluted sulphuric acid in the ordinary drink used, and another, qui- 
nine in combination with nux vomica, — for the purpose of controlling the 
diarrhoea, and calming the nervous system. 

The oil of turpentine employed according to the recommendation of 
Prof. Wood, and Dr. Jackson (of Northumberland), gave general satisfac- 
tion. 

In the treatment of Intermittent Fever , we find the following from Dr. 
Gemmill, (Report from Huntingdon Co.). 

" For the last few seasons, I have chiefly relied on the chinoidine, which I have 
found fully as certain and prompt as the quinine in arresting the paroxysms, and being 
so much lower in price than the quinine, renders it a matter of importance in a com- 
munity where ague so much prevails. In some cases, which could only be kept in 
check for a few days by the chinoidine, the quinine was used with no better effect. I 
make the chinoidine into pills with some bitter vegetable extract, each pill containing 
one grain of chinoidine, and of these I give two every two or three hours during the 
intermission, until from twelve to sixteen are taken, and on the 6th, 13th, and 20th 
days give eight or ten pills in the same way." 

" Inveterate Ague, and such cases as have become complicated with diseases of the 
liver and spleen, &c, occur throughout the whole year. In such cases, Dr. Luden has 
found the following the most successful method of administering the quinine : He 
gives the same in connection with the iodide of iron, and so that, while the dose of the 
quinine is daily decreased, that of the iodide of iron is increased. He prescribes these 
two mixtuies; R. S. quiniae J)ii — £j 5 aquae cinnam., syr. aurant. aa f ^ii. M. No. 1. 
R. Liq. ferr. iod., aq. destill., t. aurant, aa f^ii. M. No. 2. The patient takes a table- 
spoonful of No. 1 twice the first day, and once every succeeding day, replenishing the 
vial after each dose from mixture No. 2, until the latter is all used, when he continues 
with the original mixture alone until it is done." 

Our Pennsylvania brethren have paid much attention to the subject 
of the types of disease as influenced by geological formations. Their 
investigations, however, on this subject, are not yet complete. Dysen- 
tery seemed to prevail, as well, though perhaps not as generally, in sec- 



1854.] Bibliographical Notices. 219 

ticms whose formation was of the slaty kind, as in limestone regions. On 
this point the report from Huntington Co. says — 

"It remains to add, relative to the influence which different formations of soil way ex- 
ert upon constitution and disease, that last years experience has not thrown any more 
light upon the subject; nothing positive can as yet be stated, and the result of inquiry 
have proved too contradictory. The hilliness of the country, the smallness of the val- 
leys, and the short continuation of the same kind of soil, are obstacles which, as yet, 
have prevented us from arriving at any decided conclusions or important truths in 
that respect." ■ 

We hope our Pennsylvania friends will push the work of organizing 
County Societies vigorously. There are counties enough in the State for 
two grand medical organizations, one east and one west of the Alleghe- 
nies. In some of the counties, the number of qualified practitioners is, 
at present very small. This fact renders organization the more impor- 
tant. In conversation recently with a medical gentleman residing in one 
of the western counties of the State, he informed us that out of about 
twenty practising physicians in the county, but four are graduates in me- 
dicine ! 

The u Medical Association of Southern Central New YorTc" is com- 
posed of nearly one hundred practitioners residing in the counties of 
Tompkins, Cortland, Chemung, Tioga, and Broome, N. Y., with a few 
individuals from adjoining counties in New York and Pennsylvania. 

Their published Transactions which lie before us, evince a commenda- 
ble spirit of harmony among the medical men of that vicinity, and a sin- 
cere desire on their part to advance the cause of medical science. They 
have chosen the most efficient way of doing this. 

The seventh annual meeting was held at Ithaca, on the 1st and 2d of 
June last. A rather novel feature in their proceedings as published, 
consists in their almost exclusive devotion to surgical reports, — the report, 
and a paper on Hay asthma from Chemung Co., with an essay on dis- 
eases incident to California adventurers, being the only ones of a medi- 
cal character in the book. 

Dr. W. C. Wey of Elmira, mentions an obstinate case of Hay-asthma 
of many years standing, which yielded almost immediately to the follow- 
ing prescription — 

R Acid. Hydrocyanic, gtt. xxx. 
Mucillag. Acaciae f. ^ij. 
Fifteen drops to be taken every two hours. 

One item of Dr. J. S. Briggs' experience on the overland route to Cali- 
fornia, will serve to illustrate the "many inventions/ I which necessity 



220 Bibliographical Notices. [May, 

often forces upon men. In the company to which he was attached there 

were several cases of fever of a typhoid character. 

"The patients were conveyed on litters, which are constructed in the following man- 
ner: Two long flexible poles were attached at one end lo each side of a pack saddle. 
The other ends were drawn on the ground. Two short poles were made to cross 
these, forming a frame to which the sacking is attached. The patient lay on this di- 
agonally, with his head nearest the mule. The poles diverge so much at their lower 
extremities as not to be easily upset. As the poles are flexible, it forms a somewhat 
easy conveyance for the sick." 

There is not much of interest in the surgical reports, and yet a few 
items demand a passing notice. In speaking of the diagnosis and treat- 
ment of fractures, Dr. Geo. Burr says, (Report from Broome Co.), 

" Science, like law, needs a tribunal for the correction of errors, and in our profes- 
sion, he who corrects his own, and improves from the mistakes of others, contri- 
butes materially to his stock of practical knowledge, and enlarges his capacity 
for the successful practice of his profession. In the absence of a legally constituted 
tribunal as a final adjudicator of controverted questions in medicine or surgery, each 
member of the profession must, for himself, by a truthful and frank examination of his 
own and others' cases, and by a candid and free interchange of views arfd practices 
with his professional associates, correct the errors which he may have embraced, or the 
mistaken practices he may have followed." 

Regarding the amount of attention devoted by Surgeons to cases of 
fracture, Dr. B. has the following. 

" A popular opinion is somewhat prevalent, that when a broken bone is once ' set,' 
it is all that is necessary on the part of the surgeon. This opinion perhaps, many times 
affects the conduct of the surgeon in the amount of his attentions to the case. It is 
always unpleasant to attend where your visits are considered superfluous, and still 
more so, when you present a reasonable bill for your services, to have its amount de- 
murred to and disputed, on the ground that you came too often, or that you ought to 
have 'set' the bone the first time, which was all that was necessary. 

"These matters are, however, much less unpleasant than deformed limbs, or suits 
at law for mal-practice 5 and the surgeon must discharge his whole duty, if he under* 
takes to do it at all." 

Dr. Nelson Nivison ("Report from Tompkins Co.), details two cases of 

fracture of the cervix femoris within the capsule. The patients were both 

females, one eighty, and the other, sixty-six years of age. 

" In order to produce and maintain the necessary extension, and at the same time 
avoid the annoyance and irritation that any sort of fixed apparatus would necessarily 
produce, I had constructed a moveable double inclined plane, the upper plane of 
which corresponded exactly in length to the distance between the popliteal space and 
the tuberosity of the ischium of the sound side. This apparatus being covered with a 
soil pillow, and properly arranged upon the bed, the patient was placed upon it, but 
in no way fastened to it, except that several pins were arranged along each side of the 
apparatus, in such a manner as to prevent any considerable lateral movement of the 
limb. "When properly arranged, it was found that the weight of the limb below the 
knee w&s quite sufficient to make the necessary extension, while counter-extension 



1854.] Bibliographical Notices. 221 

was equally well secured by the upper end of the apparatus resting against the tube- 
rosity of the ischium. Both patients expressed themselves relieved soon after being 
placed upon it. They could sit up in the bed erect, or at any angle, or lie completely 
down at pleasure, and experienced no pain from the movements. Whereas, before 
its application, almost any motion was attended with pain in the seat of the fracture. 
This exemption from pain was no doubt owing to the reasons stated above, that the 
rough fragment of bone was drawn out of contact with the sensitive tissues that before 
had been irritated by it." 

The result, in both eases, was as perfect a cure as could be expected 
under the circumstances. 

Dr. F. Hyde of Cortlandville (Report from Cortland Co.), has the fol- 
lowing on the subject of fractures of the fore-arm, 

" I have found, that by particular attention to one rule, more certainty of good re- 
sults may be expected, and the patients saved no inconsiderable amount of discomfort, 
to wit: Before applying the two broad splints, so adjust the graduated r( compresses 
used for the purpose of keeping apart the two bones, as that they shall not exert the 
same amount of pressure upon the lower part of the arm that they do on on the upper, 
for, if they do press equally on the pronator quadratus muscle, which is running trans- 
versely to the bones, the very important principle which we are professing to carry 
out by this modification of the dressing, is more than contradicted. If we reflect as we 
apply our dressing, that the broad muscle of which we have spoken, takes hold of the 
whole lower fifth of the ulna, and a fourth of the radius,'ordinarily we cannot but see 
the importance, when our compresses are applied, of not allowing them to extend 
down so far as to allow them to press directly upon this muscle. 

"It is the conviction of the writer, that a rigid observance of this precaution in the 
treatment of all fractures of the fore-arm, whether near the carpus or not, would not 
only ensure a more perfect foim of the arm, but would prevent so long a disease of the 
parts about the wrist, as follows the application and continued pressure on the whole 
length of the member, and most assuredly it would confer more comfort upon the pa- 
tient during the continuance of the dressings." 

We should judge from the large number of tonsils reported as having 
been removed, that in that section of country there is a perfect mania for 
this species of surgery. The report from Cortland Co. by Dr. C. Green 
of Homer, winds up with the following inferences on the subject of re- 
moval of the tonsils, drawn from a pretty extended experience. 

"1. That, among the indications for the excision of enlarged tonsils, are the tenden- 
cy to frequent attacks of tonsillitis and pharyngitis ; the fear of croup in certain cases ; 
the difficult and exhausting respiration during sleep in young children. 

2. That amputation of the tonsil is vastly preferable to the attempt to reduce the hy- 
potrophy by medicinal treatment. 

3. That re-growth of the tonsil rarely if ever occurs, and that this occurrence is ap- 
parent rather than real, and is often caused by a lobed form of the tonsil. 

4. That the main contra-indications for the amputation, other things being equal, 
are, an inflamed condition of the tonsil, and the hemorrhagic diathesis. 

5. That in hemorrhage after excision, pounded ice, worn in a neckcloth, applied to 
the throat, is the remedy. 

6. That the results of amputation are gratifying. 

.7. That this operation is not resorted to with sufficient frequency." 



222 Bibliographical Notices. [May,. 

Types of Mankind : or Ethnological Researches, based upon the 
Ancient Monuments, Paintings, Sculptures, and Crania of Races, 
and upon their Natural, Geographical, Philological, and Biblical 
History, illustrated by selections from the inedited papers of S. G. 
Morton, M. D , &c, and by additional contributions from Prof. L. 
Agassis, LL. D., W. Usher, M. D., and Prof. H. S. Patterson, 
M.D, By J. C Nott, M.D., and George R. Gliddon. Phila- 
delphia : Lippincott, Grambo & Co., 1854. (Royal octavo, pp. lvii. 
and 738.) 

In all cases of scientific progress and reform, it unfortunately too often 
happens that the ground has to he cleared of the errors by which it was 
originally pre-occupied ; and that this cannot be done without some heat 
and excitement. Thus, in all advances in religious truth, the iconoclast 
must precede the constructive reformer, and with strong arm and Thor- 
hammer smite the images of the people to pieces, before they can be di- 
vorced from their old superstitions. To attack prejudices hoary with 
age, and venerable for generations, — to assail ruthlessly the opinions 
which have been inculcated into all our minds upon our mother's knee, 
is a hard task, and generally a thankless one. Always somebody 
has to do it, however, and, in most cases, to suffer for it, that his succes- 
sors may have an opportunity to push onward in the march of science. 
Just so, in the assault of a city ; many must perish and fall in the ditch, 
before it is filled, and the army can pass over into the breach and to 
victory. We make these remarks, because we have here such a case of 
Iconoclasm. The authors have aimed to demolish at one blow, doc- 
trines which have been regarded as settled, beyond possibility of cavil ^ 
by the whole christian world, and which have been doubted by scientific 
men, only of late years. The idea of the original unity of the human- 
family, and its descent from a single pair is so interwoven with our en- 
tire education, and enters so completely into all our modes of thought and 
feeling, that any assault upon it seems revolutionary in the extreme. 
We have been taught, moreover, to regard it as an essential article in 
our religious faith, and as clearly taught in the Bible. Yet here it is 
boldly and unhesitatingly denied, and alleged to be not even necessarily 
implied in the Scriptures, while it is palpably contradicted by the plainest 
facts of Nature. These assertions are not made blindly and rashly, but 
are advanced with copious arguments in their support, by cautious and 
learned men, who write with the earnestness of deep conviction. That 
they represent the opinion now prevalent among scientific men, has been 
known for some time. To those who have cultivated natural scienee, 
their developments will therefore, not be so startling. But upon the 
public they will come with the suddenness of a thunder-clap. Messrs. 
Nott and Gliddon have assumed the function of Iconoclasts, and may 
have to share their fate. Their Book will create a great excitement, and 
they will be unmercifully assailed in various quarters. No men could 
probably be found in our community, better prepared for such a fight, 
and judging from the tone of this book, they will have rather a liking 
for it. 



1854.] Bibliographical Notices. 223 

We cannot attempt, of course, to give an analysis of this superb vol- 
ume of 790 large royal 8vo pages, a large proportion of which is printed, 
for further condensation, in small type. The reader will find here a very 
full account of the geographical distribution of races, with their main 
peculiarities of anatomical structure, color, hair, &c. The Craniological 
department of the subject is very thoroughly examined. Many very cu- 
rious facts are brought out, concerning the remains of early races, now 
perhaps extinct. One of the most singular, is the evidence given of the 
existence of at least two races in Northern Europe, prior to the Celts and 
Germans, whom the Romans found there. The chapter on Palaeontology 
is by Dr. Usher, of Mobile ? who insists upon the fact that human bones 
have been found fossilized. In discussing the evidence of the perma- 
nence of types afforded by Archaeology, the peculiar learning of Mr. 
Grliddon comes into play. They show, that at a period as remote as that 
generally assigned to Abraham, their existed in the valley of the Nile 
precisely the same races and tribes that are found there now. The 
Scriptural aspect of the question is also discussed by the learned pen of 
Mr. G. 

The contribution of Prof. Agassis is particularly interesting, because 
it is an effort to construct a positive Ethnology in place of the exploded 
hypothesis. It is the view that would naturally suggest itself to a Zool- 
ogist, and consists in classifying the Fauna of various regions, (man in- 
cluded), according to their respective analogies. Thus, Australia is very 
peculiar in its type of animal forms, and its peculiar type of man will be 
found commensurate in extent with those forms. In like manner, the 
Arctic region has its distinctive Fauna, always found in connection with 
its distinctive human type. This idea is illustrated by a beautiful litho- 
graphic chart. It is not fully developed in the present work, but if the 
author can carry it out satisfactorily, he will have the honor of inaugu- 
rating a positive Ethnological science. 

The contribution of Prof. Patterson, is a memoir of the late Samuel 
George Morton, to whose venerated memory the whole book is intended 
to be a monument. Dr. P. has performed this task evidently with a 
full heart, and has done justice to his illustrious subject. We rejoice 
that the Life of Morton has thus been adequately written. We confess 
that we felt much provoked, when, in a previous publication of the kind, 
we saw the affair of Dr. Backman and the Hybridity controversy evaded 
with a sort of apology as an unpleasant matter. Dr. Morton was very 
illy treated in that whole business, and he defended himself and his po- 
sition with a boldness, calmness, and dignity that may forever serve as 
a model to men of science under like provocation. We are thankful to 
Dr. P., for having put this affair in its true light. 

The Preservation of Health with remarks on Constipation, old 
age, use of Alcohol in the Preparation of Medicines. By John C. 
Warren, M. D., &c. Boston: Ticknor, Reed, & Fields, 1854, 
(12 mo. pp. 140). 

This is an unpretending little book, but its merits are not to be mea~ 



224 Bibliographical Notices. [May, 

sured by its size, or its modest appearance. Although of limited dimen- 
sions, it is as full of practical suggestions, to use a homely comparison, 
" as an egg is full of meat." Some of the articles contained, have been 
given to the public before. We remember his remarks concerning habit- 
ual costiveness, and the use of cracked wheat as a diet in said affection, 
with great thankfulness, for they have proved of much value to us in 
practice. The observations on the medicinal use of alcohol, deserve the 
profound attention of all practitioners. Our conviction is, that Alcohol 
is even yet too much used as a menstruum. The tonic tinctures, we would 
be better without, entirely. Neither is there any necessity for the laxa- 
tive tinctures, once so much used. We see no great objection to the use 
of an alcoholic menstruum, where the dose is measured by drops ; but we 
would hesitate to give any tincture in repeated doses of §ss. It has been 
our rule for years, to use no medicine in this form, the dose of which is 
greater than a f gj . There can be no doubt, that infinite mischief has 
been done by the medical prescription of tinctures. The formerly preva- 
lent delusion, that the habitual use of a bitter tincture would prevent 
ague, has sent its thousands to the drunkard's grave. Let us be no lon- 
ger responsible, for such deplorable results. The counsel of Dr. Warren 
on this subject, is sound and practical, as it is on all others, and we 
therefore, cheerfully recommend his excellent little book to our readers. 



On Rheumatism, Rheumatic Gout, and Sciatica ; their Patholo- 
gy, Symptoms, and Treatment. By Henry W. Fuller, M. D., 

&c. New York: S. S. and W. Wood, 1854. (8vo. pp. 322.) 

To one who feels always, by day and night, the heavy sense of respon- 
sibility that weighs like a leaden load, upon the heart arid brain of the 
i conscientious practitioner of medicine, it is an inconceivable pleasure to 
find himself in possession of a book which will strengthen his hands 
and give to his curative processes a new extent and power. Such, we 
venture to prophecy, will be the sensation of many in the perusal of this 
work upon a most intricate and confused subject. No other section of 
practical medicine presents, at first sight, the same entangled mass of 
confusions and apparent contradictions, as that which treats of rheuma- 
tism, all arising as we believe, from the loose inaccurate use of terms. 
In fact, medical men employ the word rheumatism so vaguely, that we 
always decline discussing it with one, until he submits his definition, and 
we can know exactly what he is talking about. It may be a case of 
pure neuralgia, or chronic inflammation of the fibrous tissue, from cold ; 
or syphilitic periostitis, or the blood disease, which is rheumatism pro- 
per ; or gout, which is its congener. Dr. Fuller, however, is rigid in 
his definition and clear in his views. His work is full, without redun- 
dance, and learned, without pedantry. The following brief extract will 
serve as a specimen of his style as well as of the general scope of his 
opinion. 

" Thus it would appear that cold and other external agencies are only 
predisposing and exciting causes of rheumatism, and that the primary, 



1854]. Bibliographical Notices. 225 

proximate, or essential cause of the disease, is the presence of a morbid 
matter in the blood, generated in the system, as the product of a pecu- 
liar form of mal-assimilation — of vicious metamorphic action. This poi- 
son it is which excites the fever, and produces all the pains and local in- 
flammations which are often found associated in an attack of rheuma- 
tism. If the rheumatic virus be present in small quantity only, it may 
cause little more than wandering pains in the limbs, and may scarcely 
induce any perceptible force, whilst if it exist in larger quantities, it 
rarely fails to cause febrile disturbance, and to excite inflammation in 
various parts of the body. In that respect, however, the effects are 
found to vary in different cases. Sometimes, though it cause great feb- 
rile excitement^ its local agency may be confined to the production of 
external articular inflammation ; at others, it may fail to produce arthri- 
tis, but may give rise to acute inflammation of the heart ; and at others, 
again, carditis may be one only, out of several internal inflammations, 
which it sets up coincidently with extensive articular mischief. More- 
over, there appear good grounds for believing that, as in some cases, it 
gives rise to excessive febrile disturbance for days prior to the accession 
of articular inflammation, and repeatedly, without exciting inflammation 
of the heart ; so, in certain instances, it may excite the peculiar train of 
symptoms whereby rheumatic fever is characterized; without producing, 
from first to last, the slightest concurrent local inflammation, whether 
of the joints or of the heart, or any other organ." (p. 37.) 

Dr. F. also treats very fully and ably the important topic of the con- 
nexion between rheumatism and heart disease. This portion we cannot 
too cordially commend to the careful perusal and study of our readers. 
We are satisfied that a more thorough knowledge of this subject, and a 
more general attention to the first insidious approaches of cardiac disease, 
would save many a valuable life. 



Elements op Human Anatomy ; General, Descriptive, and Practical, 
By T. Gr. Richardson, M. D., &c. Philadelphia : Lippincott, Gram- 
bo & Co., 1854. (8 vo. pp. 734.) 

" Another text-book ? Is there no end to them ?" was our first excla- 
mation, on taking up this volume ; but, on looking into it, we began to 
perceive that the author did not write altogether without warrant. Our 
turning over of the leaves soon became a deliberate reading, for the style 
is simple, clear and unaffected, and we rose from our task with the con- 
viction, that Dr. R. is fully justified in offering his book to students of 
medicine, as a reliable and sufficient guide in acquiring a knowledge of 
the difficult branch he teaches. He has endeavored — and successfully, 
we think — to discuss adequately in one treatise, General, Descriptive and 
Practical Anatomy, so that the one volume will suffice. We are not dis- 
posed to contrast it with other text-books on the same branch. " Com- 
parisons are odious," under most circumstances, and we [avoid them as 
far as possible. Dr. R's.»book is superior to some that are sanctioned by 
our Schools of Anatomy, and inferior in some respects to others. As we 



226 Bibliographical Notices. [May, 

have already said, it is an amply-sufficient text-book, and the preceptor 
may confidently place it in the hands of his pupil as such. Its size and 
form are attractive, and it is got up in the very first style of mechanical 
execution. The wood cuts are numerous and elegant, and serve admira- 
bly to illustrate the text. 

A Practical Treatise on Inflammation of the Uterus, its Cer~ 
vix and appendages, and on its connection with Uterine Disease. By 
James Henry Bennet, M. D. Fourth American, from the third 
and revised London edition, Philadelphia: Blanchard and Lea, 
(8vo. pp. 430.) 

This book has been before the public long enough for the majority of 
practitioners to have made up their minds concerning it. Its popularity 
is attested by the fact, that it is in constant demand, and has already 
reached a fourth edition. Dr. B. is recognized as their great champion 
by the advocates of certain novel views in uterine pathology and treat- 
ment, concerning which there has been much animated discussion and 
not a little acrimonious controversy, that we should be very sorry to be 
engaged in. He writes like a man who is thoroughly convinced himself, 
and is earnestly resolved that he will convince his readers. This feeling 
gives a spice of vehemence to his style, which renders it more pleasant 
reading than most mere dry pathological treatises. 



Lectures on the Diseases of Infancy and Childhood. By 
Charles West, M. D., &c. Philadelphia : Blanchard and Lea, 1854, 
(8vo. pp. 486.) 

This able and instructive work, was first given to the profession in our 
country through the medical Library of Lea & Blanchard. "We noticed it 
at the time of its appearance, and have only to add now, that the more 
familiar we have become with it, the higher has it risen in our estima* 
tion. The speedy demand for a second edition, shows how well it has 
been received by the profession. The practitioner will find in its pages 
a remarkably lucid account of the peculiar diseases of infancy, with clear 
and sound practical directions for their, treatment. It is one of the books 
that a man instinctively turns to when harassed with the cares and re- 
sponsibilities of practice, knowing that he will find there aid and strength 
for his daily work. 



1854.] Editorial. 227 



EDITORIAL. 



OLD PHYSIC, AND YOUNG PHARMACY. 
A FEW WORDS WITH THE APOTHECARY. 

The noise and show of quackery, in these days of patent Elixers and 
Cure-alls, seem to have ensnared our friends of the mortar — and we have 
a few words for them.^ We hope they will take our counsel kindly, for 
though our* prescription may be difficult to compound, and still more 
difficult to take, we feel assured that it is a good one. We do not pre- 
tend to assert that physicians themselves, are just what they ought to 
be ; but still we believe, they generally observe a proper etiquette to- 
wards their brethren of Pharmacy. Let us examine our mutual rela- 
tion for a few moments. 

Apothecaries want to sell quack medicines. Doctors say it is a breach 
of fidelity, and an injury to society. Early in the history of medicine 
in this country, the Doctor's shop was the great central point, where 
medicine was prescribed, and procured. It was not the fashion then, 
to write prescriptions, but to prepare the medicine, and administer it to 
the patient ; but as the sun broke out from its early dawn, and began 
to rise higher and higher, shedding light upon the advancing world of 
mind, the doctor began to think that there were two reasons, why he 
should confer upon others the office of preparing medicine, and the ad- 
vantages, resulting from it. Chemistry whispered to him, in his mus- 
ings, that she had been silently busy in the bowels of the earth, and in 
the waters of the great deep, and had discovered some wonderful things. 
He gave assent, and bid her bring them out. She had a strong brother, — 
Pharmacy by name, who came to his other ear, and whispered strange 
and very doubtful truths, about extracts, confections, and various no- 
velties, before untold, and unknown. To this, Old Physic gave his nod of 
assent, "evacuated the principalities^ demanded of him, in a far more amia- 
ble mood than is exhibited by the Czar of Russia, and yielded the territory 
to the young conqueror quietly, both agreeing to aid each other, in the great 
work of healing. In good faith, both go on. Year rolls up against 
year ; and as the steep of time becomes more and more rugged, they yet 
hold together, and in mature, vigorous manhood, are accomplishing 



228 Editorial [May, 

more — far more, than they could have anticipated, when the intervening 
quack, without a crown of royalty to deck his brow, or a star of repub- 
licanism to enlighten his path, but with the iron step of a haughty 
usurper, comes in to sever the bond, that had united the old man, * 
with his adopted child. Now, what is the issue. The child, fired 
with the spirit of "Young America" — instead of holding on in good 
faith, to good old custom, attaches himself to the train of the usurper, 
and begins to shout with the multitude, that follow on in his dusty 
train. Quack medicines must be sold, and I will sell them. They 
must be sold, because they will be bought, and I will have the buyers. 
This is the logic — it is the logic of the day — and Young Pharmacy 
dresses himself up in gold, and glitter, shows himself at the corners of 
the streets, in significant characters, his pockets, "drawers" and all, 
stored with the spoils of the aggressor, and offers them to the passing 
crowd. 

He has left his first estate. He has become a caterer to a morbid 
moral taste, — a taste for the unreal. He must live, — this is the reason. 
He is not the author of the morbid desire for quackery. But, to accom- 
modate the public, he will supply the demand created by it, as the jew- 
eller supplies useless trifles, and trinkets, which are equally the crea- 
tures of an idle and corrupt taste. But where is Old Physic now ? He 
is still in the line of his duty. He has kept to his contract. He does 
not sell even the medicine he has prescribed. Not because he cannot, 
but because he has said, oonafide^ he would not. He sends his prescription 
to the apothecary, who furnishes the medicine " carefully compounded," 
and neatly put up, for a consideration. All right. Is there no reciprocal 
consideration, due the physician under these circumstances? Young 
Pharmacy opines not, if its return is in any way to interfere with money 
getting, not bearing in mind, that the physician has forfeited all claim 
to this end, by refusing to dispense the medicine himself. Pharmacy is 
the child of Physic. It is so in a two-fold sense. First by age, and 
second, by patronage. The business of prescribing belongs to the Pa- 
rent, that of compounding, to the child. 

A physician is in attendance upon a patient. He does not recover as 
rapidly as either party could desire. But such is the nature of the case. 
Perhaps it is phthisis, from which he cannot recover. He wants to try 
Jayne's, or Swaim's, or somebody's expectorant. The doctor objects. 
The patient sends to the apothecary to know what is good for consump-, 
tion. He is shown a bottle, on which is labelled, what the manufac- 
turer, and vender, and consumer, all know to be a falsity — an infallible 



1851.] . - Editorial 229 

cure for an incurable malady. A dollar pays for it) and it is purchased. 
The patient is wronged out of his dollar, and the apothecary keeps his 
share, while the judgment of the physician is set at defiance. But all is 
forgotten when the poor sufferer dies, except the maxim, which it be- 
hooves all to remember—that the way of trade is, in many instances, 
the way of death. This is one difficulty, Here is another. Undue 
confidence is imparted to the manufacturer of quack medicine. Those 
who sell, indirectly sanction the whole system of quackery, and sustain 
a patented pharmacy, in opposition to their own recognized system. The 
physician is responsible for his prescription, ifc being certified by sig- 
nature, and date. If it does harm, he is accountable. The apothecary, 
by selling a secret medicine, promising to cure, shares in the responsibi- 
lity, if a cure is not effected. 

Take for example, "worm medicine." It is a curious fact, that if a 
child is a little unwell, the careful mother, and knowing nurse, almost 
invariably diagnosticate worms. It picks, its nose, loses its appetite perhaps; 
and a variety of other symptoms present themselves, till, (it being a simple 
case, not requiring the advice of a physician), the apothecary is consulted, 
and Hobensack, or Fahnestock, or some other representative of the school 
of patented pharmacy, is offered in the form of a vermifuge, which will 
eject the worms if there are any, either whole or in pieces, and if not, pro- 
tect the system against them. The medicine is purchased, and administered. 
The bowels are actively purged, and violent disease is induced. Who is 
responsible ? We will not answer. This is no picture. It is a living 
fact We know that a large number of cases of sickness in children, 
to which the physician is called, particularly in the country, unless it be 
some sudden illness, have been previously treated by the family for 
worms; and we are satisfied from no very limited experience, that these 
"worm medicines," compounded by the covetous, patented by the igno- 
rant, sold with promises, and used by the over-credulous, are often the 
cause of serious mischief. Such mischief, under the treatment of a phy- 
sician, would subject him to a charge of mal-practice. But as it is done, 
by a counterfeit, with the noise of " sounding brass, and tinkling cym- 
bal," the perpetrator escapes unwhipt of justice. 

We know right well, that should the profession of medicine return to 
the "doctor shop" of olden time, our pharmaceutical brethren would feel 
like bringing their .cantharides to bite at our wandering feet, and perhaps 
with justice. May we not say to them, that they perhaps need a gentle 
sedative, a cooling draught ; — mixed it may be, with a moderate aperi- 
.30 . . 



230 Editorial. [May, 

ent, to carry off unwholesome deposits, that have already defiled the body 
social ! 

Take our prescription, and we think it will do you good. Your sci- 
ence is a noble one — and it is distinct. But so far as practical pharma- 
codynamic is concerned, leave it in the hands of the physician, and he 
will do you all the honor you may claim at his hands. 



PRIVATE PRACTICAL INSTRUCTION. 

Now that the winter courses of lectures are over, and the professors are 
resting temporarily from their arduous labors, and the majority of students 
have returned to their homes, the real wants of the claimants for the docto- 
rate, may be better known, and understood, by an inquiry into the causes, 
that induce so large a number of diligent students to continue in the 
city during the summer months. A few moments may be profitably 
spent in pursuing this subject. The vast resources of our profession, 
and its collaterals, afford a wide field for the enterprising and indus- 
trious student; as do the wonderful openings of new, and produc- 
tive territories, the uprising of young cities, and the rapid increase 
of population, offer facilities for success, and renown. If the latter 
may be gained, the former must be studied, and used. This is 
doubtless the motive power, that impels the student of medicine to 
unwearied effort in all branches of the profession. By the present 
arrangement of our Colleges, it is impossible to embrace, in the 
few months devoted to lectures, all the branches necessary to be taught, 
and' while we would not complain of the shortness of the lecture terms, 
believing, that in some instances, they are quite long enough for both 
professor and pupils, we are glad to know, that the branches not 
taught in the Schools, are pursued during the summer; thus affording 
an opportunity for improvement, perhaps far better, than could be ob- 
tained from a College course, when we consider how the lectures are 
of necessity multiplied, and the time of the pupil for private study, crowd- 
ed into the night. We refer to the following branches : — Pharmacy, as 
an adjuvant to Materia Medica, is essential to the country practitioner, 
especially, and yet he cannot study it as a science, much less obtain a 
practical knowledge of it, in the College course of instruction. It could 
be taught perhaps, but in this day of telegraphic dispatch, first course 
students especially, hurried as they are with zeal, have not the time to 
spend. They come to attend to the great principles of medicine, and 
not these minor matters ; and they have no disposition to see the regular 



1854.] Editorial. 231 

course of instruction interrupted by attention to them. This must be left 
to the listeners, who alone, are willing to scale the mount, by steady, and 
persevering effort. So with the important lessons to be learned by practi- 
cal instruction in Auscultation, and Percussion. If a graduating class was 
to consume the valuable time of the freshmen in the ranks, by gaining 
experimental knowledge under the direction of the professor, in the lec- 
ture room, or hospital ward, the moral sense of the multitude would 
be offended, and the murmur of dissatisfaction heard through their ranks. 
The same may be said of all other branches of practical instruction, ne- 
cessarily and properly excluded from the public lecture room. We will 
enumerate some of them. 

Practical Bandaging , cannot be learned, by listening to a didactic dis- 
course about it, or seeing it practiced, though its principles may be 
plainly elucidated. The theory, wrapped up in a man's brain, will not 
retain a fractured bone in situ, or restore a solution of continuity, any 
where. Manual exercise and experience are required, to remove fear, 
and embarrassment, from the young surgeon, in his early operations ; 
hence he needs practice, to ensure him confidence, and certain success. 
Surgical Anatomy : and surgical operations, are, to a certain extent, pre- 
sented during the regular course ; but there cannot be that dexterity, 
and particularity imparted, that maybe gained by special practical instruc- 
tion. Midwifery is another branch, perhaps, in importance excelling 
all others, with reference to manual experience, and yet, neglected of 
necessity, in connection with collegiate instruction. 

Having made these suggestions, by way of calling attention to the de- 
ficiency in medical instruction, a deficiency which many have been com- 
pelled to feel, but which is now more amply compensated for, than at 
any former period, it gives us pleasure to state, that a goodly number of 
young men, are continuing in our cities, pursuing these several branches, 
under the direction of gentlemen, who are conferring upon the public, 
through their small, but attentive private classes, an amount of benefit, 
that cannot be estimated. Their labors are modest, and perhaps not suffi- 
ciently appreciated, but they are bringing out the material that has been 
manufactured at the Colleges, and putting it to work. They are adding 
experience, to knowledge, while the pupil, armed with both, is enabled 
to go forth to his field of duty, prepared to endure its conflicts. 



Bulloek and Crenshaw's priced Catalogue^ which is boiind up with the present 
number of the Reporter, our readers will find very useful for reference. It may be 
separated and preserved, when the work is bound. 



232 ' Editorial, [May, 



"BLACK LISTS." 

It will be seen by the following resolutions of the Medical Society of 
the city of Reading, and the county of Berks, that they have taken very 
efficient action in regard to that numerous class of persons who patronize 
physicians without making them any just remuneration for their time 
and labor. If medical men connected with all our organizations would 
act unitedly in this matter?, our profession would receive just remunera- 
tion for their services, and, at the same time, roll the burden of non-paying 
patients upon the shoulders of outsiders. And yet we can assure the 
public, that the physician is ever ready ,to respond, night or day, to calls 
for his services without remuneration, where poverty is a true pled. Of 
the poor, it has been truly said, there are three classes — " The Lord's 
poor, the devil's poor, and poor devils V We need not explain the 
difference between them, as it is very evident. The first will always be 
attended gratuitously, and unremittingly, by the true physician. The 
Lord is their paymaster. The second must and will be attended; perhaps 
not so cheerfully as the first, as the evil one is often their paymaster. 
And as to the last, who have no paymaster, we presume the physician is 
justified in getting out of them what he can ! 

Reading, April 21st, 1854. 
Dr. S. W. Butler — Dear Sir: — By a resolution of the "Medical 
Society of the City of Reading and County of Berks," in the state of 
Pennsylvania, the undersigned was directed to forward to you, with a 
request for their publication in the Reporter, the subjoined resolutions 
which were unanimously adopted at a stated meeting of the Society, held 
April 5th, 1854 : 

Resolved, That the members of this Society communicate the names of 
patients who are upon their black list, and who remove without having 
them erased by making payment, to the Corresponding Secretary of this 
Society, along with an accurate designation of the place to which such 
persons have removed. 

Resolved, That the Corresponding Seoretary of this Society shall 
transmit the names of such delinquents to the Corresponding Secretary 
of the Society into whose circuit such removal shall have been made, and 
request said Society to make similar returns. 

Yours respectfully, 

Martin Luther, 
Rec. Sec. of the Med. Soc. of the City of Reading and Co. of Bevies. 



1854.] , Editorial. 233 

JgS^ We are happy to see, by the following Circular of the Standing 
Committee of the Medical Society of New Jersey, that they have entered 
upon their labors with zeal, and a determination to accomplish some- 
thing. We hope they will receive the hearty cooperation of the district 
reporters, and the profession generally. 

CIRCULAR OF STANDING COMMITTEE OF THE MED. SOC. OF N. J. 

It is a principal purpose in the appointment of a standing committee 
by the Medical Society of New Jersey, to have brought into one general 
view, at regularly returning periods, the results derived from observa- 
tion and experience throughout the State. Among other duties, the 
committee are required to report, at each anniversary meeting, concerning 
" the general state of health of the citizens of New Jersey during the 
preceding year, the causes, nature, and cure of epidemics (if any have 
prevailed) in any part of the State, curious medical facts, discoveries, 
and remarkable cases that may have come to their knowledge." 

It is obvious, that for the proper discharge of this duty, the aid and 
cooperation of district reporters will be quite indispensable ; and this the 
more so, as, according to the present plan of appointment, all the mem- 
bers of the committee are taken from one and the same vicinity. The 
necessity in question would appear to be met by the provision of the 
Society, that each of the district societies shall appoint a reporter, who 
shall be required to furnish the standing committee, at stated periods, 
with all the information that may present, upon the subjects before 
mentioned. But, from some cause, or causes, the provision thus made 
has failed to produce the expected effect. The committee have repeatedly 
had to report, that but few of the districts had been heard from, and in 
consequence, instead of the full and comprehensive view which was con- 
templated, and required, by the Society, an imperfect one only, could 
possibly be furnished. 

It is supposed, that the failure just noticed may generally be owing, 
not so much to a lack of regard to the interests of the profession, or the 
requirements of the Society, as to a want of seasonable care in collecting 
the needed material; that the duty which each one designs to perform, 
and desires to perform in the best manner, is frequently found im- 
practicable when the period for it arrives. But, whatever may be the 
reason, it is certain, that the failure is so frequent, and so general, as to 
be a source of serious embarrassment ; and, to guard against it in future, 
so far as they may, the present committee have deemed it proper to issue 
to the reporters this early appeal. 

The medical reputation of New Jersey must not be suffered to fail. 
The facility of correspondence throughout the State, its advantages in an 
easy intercourse with the principal seats of medical literature, and the 
actual character of the profession within its limits, give ground for a 
demand for high contributions to medical science. To answer such a 
demand, the plan of the Society, calling for regular and full reports from 
every portion of the State ; has been well devised; and nothing seems 



234 Editorial. [May^ 

wanting bat timely an 1 earnest attention, on the part of each one, to the 
duty that may have devolved upon him. 

Isaac S. Mulford, 

B. Hendry, j- Standing Committee. 

Eich'd M. Cooper, 

Camden, N. J., April btfi, 1854. 



CALL FOR A SPECIAL MEETING OF THE MED. SOCIETY OF N. JERSEY. 

Just as our last forms are going to press, we are in receipt of the 

Proceedings of the District Medical Society for the County of Mercer, 

from which we quote the following. 

" A resolution was passed, recommending the Medical Society of New Jersey to 
hold a special meeting in May or June next. The Society considered the amount of 
unfinished business, and alterations in the medical laws of the State, made during the 
last session of the Legislature without the knowledge of the State Society, of sufficient 
importance to require a meeting." 

We would commend the recommendation of the Mercer Society, to the 
attention of our readers. There was something said at the annual meet- 
ing of the State Society in regard to the propriety of a special meeting, 
and it met with no serious opposition. If a special meeting is called we 
hope the objects will be fully set forth in the call. 

Delegates to the last meeting, would still hold office according to the 
by-laws, unless new ones have been appointed since that time. 

Section 5th of the by-laws reads as follows — 

"The President, or, in case of his absence or inability, the first, second, or third Vice 
President, in numerical order, is authorized to call special meetings, when applied to 
by any four of the members, two of whom shall be members of different District Soci- 
eties, and cause notice thereof to be given by the Secretary at least twenty days pre- 
vious to the meeting, and published in five of the newspapers of this State." 

AMERICAN MEDICAL ASSOCIATION. 

This body meets at St. Louis on the second of this month. The plea- 
santness of the season, and the prevalence of general health, as well as 
interest in the proceedings, will combine to make the meeting a large 
and interesting one. We have made arrangements for a special report 
of the proceedings, which will undoubtedly reach us in season for the 
June number. 



We are reluctantly compelled once more to postpone the publica- 
tion of the promised portrait of Dr. Stevens, and with it the fourth of 



1854.] Editorial £35 

the series of articles on the American Medical Association. The whole 
is ready, and will appear in the June number. There are good and suffi- 
cient reasons for the delay, which would satisfy our readers, could we de- 
tail them. 



EDITOR'S TABLE. 



The People's Gazette. This publication, which was started as a ''People's Medical 
Gazette" has, we perceive, become a monthly "Medical, Scientific and Literary Maga- 
zine? and is still edited by its originator, Dr. John Pa vis. Physicians are very apt, 
when they forsake their legitimate calling and dabble in general literature, to have 
their mental vision blinded by interest, and cater for popularity by abusing their pro- 
fession ; for singularly enough, there is scarcely anything that is enjoyed more by the 
public, than a joke however stale it may be, at the expense of the medical profession. 
We trust Dr. Davis will guard against this propensity. He may. in his present posi- 
tion be able to serve the cause of medicine, and therefore the cause of humanity, and 
we hope he will embrace every opportunity of doing so. We wish him success. 

The Gazette is published by T. Moore Knox, at Abbeville, S. C. Terms — one dol- 
lar per annum. 

On the subject of Priority in the Medication of the larynx and Trachea, by Horace 
Green, M. D. (Republished from the American Medical Monthly for April.) Solo- 
mon, who " spake of trees, from the cedar tree that is in Lebanon, even unto the hys- 
sop that springeth out of the wall:" who "spake also of beasts, and of fowl, and of 
creeping things, and of fishes" — and who " spake three thousand proverbs, and his 
songs were a thousand and five," has left on record this remarkable saying: a There 
is no new thing under the sun. Is there anything, whereof it may be said, ' See, this 
is new V it hath been already of old time, which was before us." 

We do not remember to have seen in Abbott's Egyptian Collection in New York, 
anything like Dr. Green's tongue spatula and probang for introduction into the larynx. 
Dr. Abbott, in his Egyptian researches, surely forgot to look for those instruments. 
We recommend the New York Academy of Medicine to send their "ancien secretaire " 
Dr. John G. Adams, on a pilgrimage to see if he cannot discover something of the kind! 
No doubt he would succeed, as he seems to be very anxious to deprive a country- 
man of the credit of introducing a mode of medication, which experience has shown 
to be beneficial to mankind. We are not deeply versed in the natural history of the 
<; New York Cliques," and know not to which the two men named above belong, or 
how Dr. G's. paper is received by the profession of that city; but we think he has es- 
tablished his claim to priority beyond a cavil, and hope Dr. Adams, "ancien secretaire " 
&c, will turn his attention to something else than claiming for foreigners, what justly 
belongs to our own physicians. We have little doubt from what we have heard, that 
Dr. Green has abused his specialty— and thrust his probang into throats, when he 
might as well have thrust it into any other opening of the body, to reach the disease 
of the patient : yet there is no doubt but his peculiar mode of applying nitrate of silver 
to the larynx, is often useful and proper. We presume much of the opposition to Dr< 
Green's claim, arises from the abuse spoken of. We hope we shall never discover 
anything — we would gain nothing by it but trouble and vexation, while mankind 
would lose nothing, as it would soon be proved that we had been anticipated in it by 
others. 



236 Editorial. [May, 

- Annals of Science / being a record of Inventions and Improvements in applied science — 
including the Transactions of the Cleaveland Academy of Natural Sciences. Conducted 
by Hamilton L. Smith, A. M., Cleaveland, Ohio: monthly; twenty eight large pages 
— one dollar a year. We heartily commend this excellent publication to our scientific 
readers. A work whose objects and aims are so good, should receive a hearty support 
from the medical profession. The following table of contents of the April number, 
will show the character of the publication. Structure of the Liver — Artificial propa- 
gation of Salmon — Manufacture of Iron for Shipbuilding-— Sulph. of Lime in Agricul- 
ture — on amorphous phosphorous — on the mixture of homogeneous colors — on deep 
sea-soundings — Arctic discovery — Natural printing process — Standard of Length and 
"weight — examination of deep sea soundings — Pnotographic delineation of microsco- 
pic objects — Angle of aperture in Microscopes — Proceedings of the Cleaveland Aca- 
demy — on the Vanessa furcillata of Say — New fish, Alburnus acutas, Lap.— The 
ocean, its origin and phenomena — Dark ring of Saturn — Mosses in the vicinity of 
Cleaveland — On the physiological effects of Coffee — New metal, Aluminum — Che- 
mistry of Photography — The Polar regions — Arctic regions — New Planet — Photogra- 
phic printing — New Comet. 

SsgTThe March number has not come to handl Please forward. 

History of the Epidemic Yellow Fever at New Orleans in 1853: By E. D. Fenner, 
M. D., &c, &c, New York, Hall, Clayton $ Co., 46 Pine street. 

This is a valuable publication. Histories of epidemics are medical histories of 
the times. We propose as soon as we can, to avail ourselves of this work in giving 
our readers an outline of the history of the terrible scourge which visited our southern 
borders the past year. 



MISCELLANY. 



The ship Tonawanda recently arrived at Philadelphia, from Liverpool, having lost 
about fifty passengers out of nearly 700, by the Cholera. The disease broke out after 
the vessel had been at sea a few days, and ceased entirely on approaching some lecher gs 
which were encountered on the passage. 

A free colored woman recently died at the City Hospital in Mobile, aged 146 years! 
Within a few days three colored people have died in this city, (Burlington, N. J.,) at 
the age of between 95 and 100. 

The Geneva Medical College having been reorganized, will commence its first ses- 
sion of sixteen weeks, on the 4th of Oct. next. The Faculty consists of James Had ley, 
M. D., and James Webster, M. D. Emeritus Professors, William Sweetzer, M. D., 
Institutes and Practice of Medicine, Thos. Rush Spencer, M. D., Mat. Medica, and 
Gen. Pathology, Joel E. Hawley, M. D., Principles and Practice of Surgery, Chas. 
Ap. A. Bo Wen, M. D. Anatomy and Physiology, John Fowler, A. M., Chemistry and 
Pharmacy, and Frederic Hyde, M. D., Obstetrics, Diseases of Women and Children, 
and Medical Jurisprudence. 

The bill appropriating $100,000 to the discoverer of Anaesthesia, passed the United 
States Senate, on Wednesday, April 19th. To the claimants named in our March 
number we have now to add the late Dr. Samuel Guthrie, who, it is claimed, made 
the discovery in 1831, and Dr. Dickson, 



1854.] Eclectic and Summary Department. 237 



ftECROLOGICAL RECORD. 

Died, in Fairham. Mass., March 5th, Dr. John V. Miller. Dr. M's. death was 
caused by a dissecting wound. He had just completed the course of lectures in Boston. 

In Brooklyn, suddenly, March 9th, Dr. Patrick H. Morris, an Alderman of 

the fifth Ward of New York. 

On the evening of Feb. 14th at his residence, near Readington, N. J., Dr. Jo- 

siah Quimby, aged 61 years. 

In Boston, March 18th, Dr. Geo. C. Shattock, in the 71st year 'of his age. His 

disease was, an affection of the heart. Dr. S. was a man of great professional and per* 
sonal worth, a liberal patron of his Alma Mater, Dartmouth College and of Harvard 
University, to which he recently gave a donation of $15,000 for the purpose of estab- 
lishing a Professorship. 

• ■ In Paris, March 23d, the distinguished surgeon Roux, in his 7ith year. 



ECLECTIC AND SUMMARY DEPARTMENT. 



ON THE USE OF ALCOHOL IN MEDICINE. 

I have already wearied you with this long and too uninteresting address; but I 
would hide my face in shame ; memory would hereafter be to me a curse, if I should 
permit this occasion to pass without calling your attention to a subject which, as the 
conservators of the public health, as scientific physicians and honest men, we are 
bound to examine. I allude to the use, by medical men, of alcoholic drinks. Look at 
our county reports; see what interest is manifested to ascertain the causes of diseases. 
Malaria, variations of temperature, drought and moisture, geological formations, south- 
ern exposures, filth and poverty, and other minor causes are brought forward ; but 
how insignificant do they all appear, when contrasted with that cause which, " defying 
all competition and comparison, stands alone in its acknowledged and detestable 
supremacy." The miasmata that produce fever are active but for a few weeks, cannot 
rise above the neighboring hill, and may be hemmed in by the smallest rivulet. The 
malignant dysentery that skirts along the gravelly slope, leaving death in its path, has 
not power, if we believe your reports, to taint the air that sweeps the neighboring 
limestone valley. The east wind that comes laden with cold and moisture, and causes 
a thousand mothers to start from their beds, as they hear the croupy cough of their 
little ones, gives way ere to-morrow's noon to the genial breeze of the south, or the 
healthful northern blast ; while filth and poverty, sufficient to form a nidus for disease, 
scarcely hold a place even in our most crowded cities. But this pet of ours, which 
we introduce to all classes of human society by our example, which we force into 
every house by our precepts, rides over hill and mountain, sweeps every glen and 
valley, with a poison as fatal on the summits of the Alleghanies or the peaks of the 
Cordilleras as in the lowest, filthiest marsh of our country. It laughs to scorn the san- 
itary measures devised by physicians to arrest the spread of cholera, and, filling the 
blood with corruption, presents to the Eastern scourge thousands of helpless victims. 
It is operative in every sea — exerts its pestiferous influence as certainly among the 
dwellers in the regions of eternal frost as upon the wandering Arab, amid Sahara's 
" shrubless hills of sand," or on the luxurious grandee, whose home is amid the orange 
ol 



288 Eclectic and Summary Department. [May, 

groves of the Queen of the Antilles. It respects neither age, nor sex, nor occupation 
— regards neither wealth, nor honor, nor place. The high, the low, the rich, the poor, 
are all stricken, and fall upon every side of us, and yet with their last brvath they suck 
in its poisonous vapor and cherish it as their last, best hope of life. How is this? Are 
we responsible for this state of things ? We are. It is proved beyond cavil, that typhus 
fever and cholera are propagated by filth and rendered harmless through cleanliness. 
How important this discovery-^ who can calculate the advantage to Philadelphia of the 
sanitary measures directed by physicians, during the late visit of cholera, to this city. 
They snatched from its grasp all but the intemperate. Could the physicians of this 
city be considered honorable men, if, knowing the means to avert a widespread and 
malignant epidemic, they should fail to urge their adoption, in the earnest language of 
men anxious for the welfare of their fellows? Assuredly not. 

"What is our position before the world in relation to the use of intoxicating drinks? 
We profess to a knowledge of the laws of health, to know what is useful and what in- 
jurious to the healthy human system ; and with great gravity and much show of anxiety 
for the welfare of others, descant upon the injurious tendency of coffee and tea, expo- 
sure to night air, thin clothing, certain kinds of food, &c, &c. ; but at the same time we 
make daily use of alcoholic drinks as a beverage for ourselves; we recommend them, 
on many occasions, to our friends ; we offer them to those who socially visit us ; we 
invite the students to our social parties, and, regardless of their parents' agony, " put 
the bottle to their mouths, and make them drunken." Nor do we stop here. The 
professor teaches that it is a valuable remedy for disease. The graduate passes into 
the community — and, in dysentery, typhoid and typhus fever, cholera, and many other 
diseases, and in every phase of real or apparent weakness, prescribes it for his patient; 
thus, not only fostering that fierce appetite for alcohol, that ceases only with death, but 
impressing the community with the belief that alcoholic drinks are absolutely essential 
to the preservation of health and the cure of disease. What can moral suasion do? 
What can. the Maine Law effect in opposition to such a sentiment among the masses, 
founded, sustained, and encouraged by the voice of the medical profession? Our po> 
sitipn should be, that alcoholic drinks are injurious to the healthy human system, never 
necessary as a preventive of disease, nor absolutely essential to its treatment. Is there 
a disease of the heart, the head, the lungs, the liver, or the kidneys, that has not beeu 
produced, a thousand times, by alcoholic drinks? Is there a single one of those dis- 
eases which demands their use as a remedy ? 

J)r. Edwatd H. Barton, in his sanitary report of New Orleans, made to the American 
Medical Association, says: " I have received an official document from G. W. Powellj 
Esq., G. W. Patriarch of the Sons of Temperance in this city, exhibiting the mortality 
a^mpng the members of that body during the last two most fatal years known to this 
city, when it has heen scourged by the combined influence of yellow fever and cholera, 
with an acknowledged mortality from them of 5653. Of the 2427 members there have 
died, in two years, but twenty nine, or one in 834}. This most valuable report goes 
on farther to state in detail, that of this mortality, eight died of yellow fever, and only 
two of cholera : that one-third of those were transient brethren visiting for their health ; 
and, moreover,that nine-tenths of all those members were of that very age (from twenty 
to forty) most subject to the malign influence of this climate." He further says : " My 
second proof, bearing on this subject, is the influence of climate upon that sex who 
are proverbially temperate everywhere. Of the large mortality by yellow fever during 
the last eight years but about one-seventh was females. But there is another proof. 
Incarceration in prison most fully protects the inmates; this it does by controlling their 
habits. In Mexico, the same immunity occurred with those incarcerated duriiiglhe 



1854.] Eclectic and Summary Department. 239 

prevalence of cholera — and, from the same cause, scarcely a case occurred, among 
the temperate, in its present visitation in New Orleans." Doctor Hosack, too, has 
said, that, " in consequence of the habitual temperance of the Society of Friends, one- 
half of the members live to the age of forty-nine, and one in ten lives to be eighty: 
whereas the average of human life is only thirty-three, and not more than one in forty 
lives to be eighty." The injurious effects of spirituous liquors have long been known. 
Trotter wrote, that of all the evils of human life, no causeof disease has so wide a range* 
or so large a share as the use of spirituous liquors. Willan declared that the use of those 
liquors, in large cities, produced more disease than confined air, unwholesome exhalations y 
and the combined' influence of all other evils. Paris said that ardent spirits produce morC 
than half of all chronic diseases. Munro asserted, that a man had no more need of 
ardent spirits than a cow or a horse ; and Kirk, that fifteen out of twenty cases of liver 
complaint were caused by them. Every writer, on the diseases of tropical climates, 
testifies to their injurious effects, and Prof. Chapman affirmed, that the evils of Using 
them are so great, that the emptying of Pandora's box was but the type of What had 
been experienced by the diffusion of those liquors among the human species. Such 
are the opinions of men, eminent in our profession, and their testimony finds a response 
in the breast of every physician; and yet we act as though alcoholic drinks were not 
causes of disease, but preventives of sickness, and valuable remedial agents. In 
nearly every part of our country, alcoholic liquors are freely prescribed, not only in 
low fevers and malignant dysenteries, but in convalesence from any severe disease^ 
and in weakened conditions ofthf: system. By the report of the auditors of the Block- 
ley Almshouse for 1S50, we are told that they used in the medical department 725 gal- 
lons of wine, 468 gallons of brandy, 248 gallons of alcohol, 15,840 bottles of porter, 
and nearly $3,000 ot drugs and medicines. The inmates averaged l,Wl3 per month. 
It would be satisfactory and useful to us to know in what diseases, and under what 
conditions this large amount of spirituous liquors was Used. During the last winter I 
heard a professor of midwifery, while lecturing to his large class, on the subject of 
flooding, urge upon them, in every case where they expected to be called, and had 
. reason to apprehend flooding, to have a bottle of brandy- provided, and ready in the 
house of the patient. Now, when we know how many valuable people have been 
made drunkards by brandy and wine, wine bitters, tinctures, Wine and egg prescribed 
for weakness and indigestion, as well as by the stimulants used in convalesence; and 
above all, by those used under the belief that they are valuable to prevent and cure 
disease, we ought, surely, to prescribe them with the greatest tdtltidn, and never, if a sub' 
stitute can be found,. Are they useful in the diseases noticed in our reports? Dr. 
Baskin, of Mercer County, in his report on epidemics, thinks them decidedly injurious 
in typhoid fever, and says: "When death from prostration was feared, quinine and 
carb. ammonia in animal broths were much better." But Dr. De Leassure, of the same 
place, gave brandy very liberally. Dr. Brodie, in thirty-three cases of ly*phus fever, 
which occurred in Detroit in 1851, treated them all on the antiphlogistic pmn, and never , 
until convalesence had commenced, gave any alcoholic stimulants. He lost but one case. 
Why did he use the alcohol after they began to get well? Would not the improve- 
ment have continued, or some tonics have been sufficient ? The committee reporting 
for Kentucky and Tennessee, says: " It is difficult to select the time in dysentery for 
administering diffusible stimulants, but when other medicines had been pushed as far 
as would do, we used camphor water, brandy and water, &c, but preferred the cam- 
phor water mixture in small doses." Dr. Ferriar, of Mississippi, speaking of the treat- 
ment of typhoid fever, says : " In depressed conditions of the system, I gave serpentaria, 
wine-whey, vol. alkali, or brandy-toddy. In most cases the serpentaria, vol alkali, or 



240 Eclectic and Summary Department. [May, 

wine-whey will best fulfil the intentions." Is there a roan present who believes them 
absolutely essential to the treatment of any disease? Can they, in typhoid fever, be 
used in that condition of the system in which Jackson, of Northumberland, and Prof. 
"Wood speak of turpentine, as almost a specific? In other diseases, where stimulants 
are indicated, will not turpentine, capsicum, ammonia, camphor, serpentaria, or ether 
answer? In convalescence have we anything better than the tonics and aromatics ? 
Will brandy stop a flooding as certainly as ergot and sugar of lead ; and, when arrested, 
will not tonics and food be more useful to the exhausted patient than alcohol? Think, 
gentlemen, of five hundred young physicians being annually sent from this city, to the 
various States of the Union, to practice their profession, placing the brandy-bottle in 
thousands and tens of thousands of houses as a remedy against flooding. Who can 
calculate the mischief that they will produce? It were better for mankind had they 
never been born. But we have some authority for believing we should cease to pre- 
scribe intoxicating drinks. Dr. Chapman, in his Materia Medica, says: " It is the sa- 
cred duty of every one exercising the profession of medicine, to unite with the moralist, 
the divine and the economist, in discouraging the consumption of those baneful arti. 
cles; and, as the first step in the scheme of reformation, to discountenance the baneful 
notion of their remedial efficacy." Professor Sewell, of Washington, remarks; "While 
we are convinced that there is no rase in which ardent spirits are indispensable, and 
for which there is not an adequate substitute, we are equally assured, that so long as 
there is an exception allowed, and men are permitted to use it as a medicine, so long 
we shall have invalids and drinkers among us. Only let our profession take a decided 
stand upon this point, and intemperance will soon vanish from our country." Prof. 
John C. Warren writes ; " The reservation of the use of alcohol, for cases of sickness, 
appears to be of little importance, in a medical way ; and, if it lead to practical abuses, 
such reservation should not be made." 

Time forbids me to say more than merely to ask that the County Societies be di- 
rected to examine the subject, and report to the next meeting of the Society ; so that 
we may unite in an earnest declaration that alcoholic stimulants are not necessary in 
the treatment of any disease. From that moment, Pennsylvania will be relieved from 
much of her disease, crime, and pauperism. Were I a professor of midwifery, or of 
the practice of medicine, and believed brandy essential to the treatment of a single 
malady, I would appoint a solemn fast-day, on which to address my class. I would 
clothe the hall with the drapery of woe — would attire myself in mourning, and, invok- 
ing the presence of genius degraded — of female loveliness and virtue deformed and 
outraged — of parental and filial affection, turned into bitter and burning hate by the 
use of intoxicating drinks; would, in the mournful accents of grief, discourse to my 
pupils on the darkness of the nineteenth century, which had, in this single case, fui- 
nished no substitute for that agent, which has filled the world with disease, sorrow, 
and premature death." — From Dr. Corson's Address. 

Treatment of Ulcers. — Dr. Henry S. Patterson, in the March No. of the Medical 
"Examiner, calls attention to the treatment of Ulcers of the Leg by the Chalk Ointment 
and tight bandage of Mr. Spender of Bath. The tight bandage, so useful in the treat- 
ment of varicose veins, is recommended here, because it is found that such a condition 
of these vessels, either of the main trunks or the smalier superficial veins, attends four 
fifths of the cases of Ulcers of the Leg, and hence come '• an impeded and imperfect 
circulation, and impaired vitality of the tissues of the limb, and the liability to ulcera- 
tion, and the difficulty of healing an ulcer when once formed. Obviously the first step 
in the treatment of such ulcer, is to remedy this primary morbid condition," The~ob- 



1854.] Eclectic and Summary Department. 241 

ject in using the Chalk Ointment, is as nearly as possible to imitate the process of na- 
ture by forming an incrustation over the whole sore, and, thus protect the newly 
forming cicatrix beneath it. The formula preferred by Mr. Spender, and recommend- 
ed by Dr. Patterson is as follows: — 

Take of Prepared Chalk, - 4 lbs. 
Fresh lard, - - - 1 " 

Olive Oil, ... 3 ozs. 

"To the lard and oil melted together, the chalk should be added gradually, being 
first rubbed to a fine powder and passed through a sieve. The mass should then be 
stirred until nearly cold." Dr. Patterson adds--" in private practice, I have used an 
ointment prepared with the precipitated Carbonate of Lime, which is perfeclly smooth." 
The ointment is spread about the thickness of a water, upon linen or cotton cloth, 
and applied over the whole sore, extending some distance beyond its margin. Over 
this the bandage should be applied by the surgeon himself. Afier a few days, if the 
dressing of the limb becomes again necessary, the ointment and bandage should be re- 
applied, without either wiping or washing the limb, so that the reparative process may 
not be interfered with by removing the incrustation. 

"This treatment," says, Dr. P., " I can, from extended experience, confidently re- 
commend to my professional brethren. It is applicable to all ulcers of the leg in which 
a varicose condition of the superficial veins constitutes the element of difficulty and 
delay in the cure, and these .will be found, (I am satisfied,) to be four-fifths of all the 
cases that occur." 



Contributions to Pharmacy. — By John P. Mattauer, M. D., LL. D., of Virginia. — 
It will not be denied that the operation of therapeutical agents is essentially influenced 
by the mode by which they are prepared. 

The fact, so generally true, is particularly exemplified in the preparations of cincho- 
na, cantharides, colchicum, guiacum, and several other medicinal substances of which 
I shall speak presently. 

For more than twenty five years, my attention has been particularly directed to this 
subject, and, during this period, I have adopted several new methods of preparing 
some of the articles of the materia medica, and have satisfied myself, by repeated 
practical trials, that these preparations possessed superior efficacy to those generally 
employed. 

Many years ago I prepared an acetous infusion of cantharides, 1 * for blistering pur- 
poses. This infusion was first designed for vesicating the scalps of infants, without re- 
moving the hair ; and its action was very satisfactory. It was applied simply by wet- 
ting the surface of the head, and hair nearest its roots, and then carefully covering the 
parts with a cabbage leaf, or oiled silk, to prevent the too sudden evaporation of the 
blistering fluid. When other parts of the body were to be blistered, a thin compress 
of bibulous paper, or cloth saturated with the infusion, was applied to them, and care- 
fully covered with oiled silk. To insure speedy and effective vesication, I usually re- 
applied the tincture two or three times, after intervals of half an hour; I found this 
agent equally as efficient and Certain in its action with adults as with infants. It ren- 
dered the removal of the hair unnecessary, as it blistered every part of the surface, 
even when a very thick head of hair existed. This preparation has been used by 
many of my medical friends and with entire satisfaction. Within the last ten years, I 
was induced to prepare an oethereous solution of cantharidesf as a vesicant, and have 

*R. Canth. contus.,^iiss.; Acid acet., Oij. Digest for 14 days, and filter. 

f & . Cantharid. contus., ^i>J.J Spirit, oeth. nitric, Oiiss. Digest for 8 days, and filter, 



212 Eclectic and Summary Department. [May, 

found it far more prompt and certain in its operation than the acetous infusion. It may 
be applied in the same manner as the latter. Frequently, merely wetting the skin 
with the solution, without covering the part, will blister ; especially in infants. When 
adults are to be blistered, the preparation should generally be applied with a thin com- 
press, and carefully covered, as already suggested, — moistening the compress 
from time to time, until the skin is entirely reddened. I have found this by far 
the most convenient and reliable means of blistering that I have ever employed. The 
cetheral tincture of cantharides is also an efficient internal remedy. As an emmena- 
gogue and diuretic it has greatly exceeded my expectation. The cetherous men- 
struum seems not only to promote the operation of the cantharidin upon the genito- 
urinary organs ; but at the same time to guard against strangury. I now use this pre- 
paration of cantharides almost exclusively, both externally and internally, when 
the lytta is indicated, and have done so for seven or eight years. 

The remarkable efficacy of the cetherous preparation of the Spanish Fly induced me, 
five years ago, to employ spirits of nitric cether as a menstruum for cubebs, colchicum, 
guiacum, squill, ergot, gossypium, sanguinaria, ipecacuanha, digitalis, nux vomica, and 
some other articles of less importance. The cethereous tincture of cubebs* is a most 
valuable remedy in all the sub-acute inflammations of the bladder, of the urethra, of 
the uterine cavity, and of the mucous lining of the stomach and intestines. It should 
be administered in some mucilaginous vehicle. 

The tincture of colchicumf is applicable to the treatment of all of the cases demand- 
ing the use of the colchicum, and is decidely preferable to the vinous seminal tincture 
now in use, by reason of its tendency to act on the urinary system. It is very well 
adapted to the treatment of sub-acute rheumatism, gout, oedema, and neuralgic rheu- 
matism, especially if the urinary secretion is materially diminished in quantity. In the 
bloating occasionally connected with dysmenorrhcea, a combination of this tincture 
with the cethereous tincture of cantharides, sanguinaria and gum guiacum will be 
found a most valuable remedy. It should be taken three or four times daily in an in- 
fusion of pine tops, in doses of ten to twenty drops each. The same combination will 
also be found valuable in the sub-acute stage of gout and rheumatism. 

The cethereous tincture of gum guiacumj is superior to the preparations of that ar- 
ticle now in general use in the treatment of rheumatism by reason of its tendency to 
act on the urinary system; and the same may be said of it as an emmenagogue when 
there is rheumatic irritation of the uterus as an associate cause ofdysmenorrhcea. 

The cethereous tincture of squill § is adapted to all cases in which squill is indicated, 
and is an elegant preparation. In dropsy, oedema of the mucous lining of the larynx, 
and of the lungs, in asthma, and as an expectorant and diuretic it will be found a most 
convenient and valuable preparation. A combination of equal parts of this tincture 
and of the syrup of lobelia inflata taken three or four times daily, in doses of 3ss. to^j 
each, is the most efficient remedy I have ever used in asthma. 

The cetherous tincture of ergot|| is best suited to cases of inaction or torpor of the 
uterus connected with debility or exhaustion ; it may be used either as an emmena- 
gogue or as a parturient. In uterine haemorrhage, or menorrhagia dependent 
on debility, or exhaustion of the uterus, it will be found a valuable remedy. Its 
action upon the uterus is greatly influenced by the cethereous menstruum. It is best 

*R. Pip- cubeb. contus., ^iv. ; Spirit, oeth. nitric, Oij. Digest 8 days and filter. 
-J-g.. Sem. colchic. contus., ^iv. ; Spirit, oeth. nitric, Oij. Digest 10 days and filter. 
t]£, Guiac. gum. resin, ^iv.; Spirit, oeth. nitric, Oij. Digest 8 days, and decant. 
SR. Scill. maritim. contus., giv, ; spirit oeth. nitric, Oij. Digest 8 days, and filler. - 
1IR. Ergot, contus., *ij. : spirit oeth. nitric, Oj. Digest 10 days and filter. 



1854.] Eclectic and Summary Department. 24S 

to give il in some diuretic vehicle, such as pine tops tea, or flax seed or elm tea ; and 
it may be taken in doses of ~ss. to gij. once in four or five hours. 

The tincture of gossypium^ is possessed of properties very similar to that of ergot 
and may be employed in like doses with it, and in similar diseases. 

The tincture of sanguinariaf is valuable when combined with the tinctures of can- 
tharides, guiacum, colchicum, cubebs, and indeed any other emmenagogue, in the 
treatment of dysmenorrhea. It is also a valuable expectorant and diaphoretic in pneu- 
monia, bronchitis, and oedema of the mucous lining of the air passages. It is adminis- 
tered in doses from gss. ^o 2i'j., once in three or four hours. This tincture may also 
be employed alone as a diaphoretic and expectorant. 

The oethereous tincture of ipecacuanha^ is so closely assimilated to the tincture of 
the sanguinaria in its therapeutical properties, as to be applicable to the treatment of 
the same diseases. It is an elegant and most convenient preparation. In typhoid fe- 
ver it will be found far superior to the ipecac pill as a diaphoretic, especially when the 
tongue is dry and the thirst urgent. It may be used also in typhus fever, or indeed in 
any febrile affections during the sub-acute stage. This valuable preparation acts both 
as a diaphoretic and diuretic in these cases, as well as an expectorant. 

The oethereous tincture of digitalis § is a far better preparation than the alcoholic, 
on account of its greater activity; and this it derives chiefly from the oethereous men- 
struum. In doses from zss. to zj., in some diuretic infusion, taken three times daily, 
it will be found well adapted to all such cases as require the foxglove. 

The oethereous tinctnre of nux vomica || is especially indicated in the treatment of 
seminal debility, or to speak more properly, debility of the generative organs. In this, 
the gravest of human ills, after such preliminary treatment as may be demanded for 
the correction of constipation, and prostatic tenderness, this tincture will be found a 
most excellent means of restoring the erections. It is also valuable in exciting appe- 
tite for food, and in the invigoration of the digestive organs. This preparation is well 
adapted likewise to the treatment of paraplegia, especially when the bladder and 
rectum are implicated, as well as such other forms of paralysis as demand the nux vo- 
mica or its alkaloid. It may be given in doses from gss. to 2[iss. three times daily, be- 
fore or after meals, in some bitter infusion. The cold infusion of wild cherry bark I 
have generally preferred as a vehicle for it. 

The oethereous solutions or tinctures are more readily prepared, requiring to be di- 
gested for a less time than the alcoholic, and keep without the least deterioration. 
They are also adapted to those conditions of the constitution in which alcoholic men- 
strua would be objectionable. 

Hydrargyrum cum creta. This valuable preparation of mercury is usually formed 
by triturating ^iij. mercury with ^v. of prepared chalk, until the globules are extin- 
guished. This is a tedious process, and the resulting powder is not of uniform strength, 
nor is the mercury completely rubbed down. Indeed, it is questionable whether the 
powder, when apparently well formed, always contains mercury, as a compound may 

*R. G-ossypii. herbac, ?iv., spirit, oeth. nitric, Oij. Digest for 10 days and filter. 

■j-R. Sanguinar. canadens. contus, ^iv. ; spirit, oeth. nitric, Oij. Digest 8 days and 
filter. 

tR. Cephael. ipecac, rad. contus., gij. ; spirit, oeth. nitric, Oij. Digest 8 days and 
filter. 

§R. Digital, purp. fol., 5iss. , spirit, oeth. nitric, Oij. Digest for 10 days and filter. 

IIR. Nucis vomicae pulv., ^ij., spirit, oeth. nitric, Oij. Digest for 10 days and filter. 



244 Eclectic and Summary Department. [May, 1854.] 

be readily formed by uniting other coloring substances with chalk, to imitate blue 
mercurial powder; and I think I have met with such imitations several times. The 
blue powder that I have procured from the shops has generally disappointed me; and 
for a number of years I have prepared it myself according to the following method : 

Take one part of pure starch; eight parts of prepared chalk; and sixteen parts of 
mercury. Reduce the starch to fine powder. The chalk may now be added, and after 
being well mixed, the mercury can be united. The powder must next be moistened 
with water, but not to the extent of wetting it ; and the whole rubbed until nearly dry, 
when the mass should be again moistened and rubbed dry. In this manner the pro- 
cess must be repeated from time to time, as may be convenient, until the powder as- 
sume i a uniform bluish appearance. After the chalk seems to be saturated with the 
mercury, rub the mass perfectly dry, and then moisten it sufficiently to make it adhere 
to the surface of the mortar by pressing with the pestle. By carefully passing the pes- 
tle over the adhering mass, so as to render its surface smooth, the superfluous mercu- 
ry will now escape from it in small globules and fall to the bottom of the mortar, and 
the separation may be facilitated by striking the bottom of the mortar against the table 
repeatedly, and by pouring the mercury over the surface of the mass where any glo- 
bules appear. The mercury may now be removed from the mortar ; and as soon as 
the mass becomes sufficiently dry, the trituration must be renewed and continued un- 
til the mass becomes a smooth, dry powder. Prepared according to this method, I 
have used blue powder in my practice more than twenty-five years, and have uni- 
formly found it far more certain in its operation than that obtained from the shops. 
I prescribe it in the ordinary doses, or nearly so, and yet I am satisfied it is stronger 
than that in general use. I invariably directitto be administered nearly dry, united with 
brown sugar, and to be mixed in a cup by stirring the powder and sugar together with 
a straw or the point of a knife. The dose may then be taken into the mouth and 
swallowed, first with the saliva, and afterwards with a mouthlul of water. This pow- 
der should never be mixed in a silver spoon, or in any other utensil possessing an affi- 
nity for mercury, or the powder may be rendered entirely inert; and such an accident 
once befell a patient of mine, who nearly lost her life before the cause of failure of the 
medicine in producing its proper effects was discovered. — Virg. Med.and Surg. Jour. 



DEATH OF PROF. PATTERSON. 

We are pained to announce the decease of our friend and co-laborer, 
Prof. Henry S. Patterson, M. D., of Philadelphia. Dr. P., who has 
long been an invalid, died on the 27th of April, in the 39th year of his 
age. A full notice of his death and its causes will appear in a future 
number of the Reporter. The present number contains his last con- 
tributions to medical literature. His bereaved wife has to mourn a double 
loss, as it is but a few weeks since their only son was buried. 




. i i p .. , 

Pr -■ ' - i ins ' i 



Kn-g Ex iVi the oxter 



THE 

KEW JERSEY MEDICAL REPORTER. 

VOL. VII. JUNE, 185 4. NO. VI. 

AMERICAN MEDICAL ASSOCIATION. 

History of the American Medical Association. 

NUMBEIt IV. 

BY ONE OF ITS MEMBERS. 

The doings of the second National Convention, held in May 1847, 
were noticed more or less in detail by the Medical Periodicals through- 
Out the country. And with few exceptions, these notices were couched 
it terms of decided commendation. Several of the medical periodicals 
in this country were conducted by Professors in the Medical Colleges, and 
a majority of them regarded the action of the Convention in reference 
to extending the College term io six months, as unwise and impractica- 
ble, but otherwise warmly commended its doings and objects. Dr. Sam- 
uel Annan, one of the Professors in the Transylvania University, the 
oldest medical school in the West, carried his objections much farther, 
and reviewed the proceedings of the Convention at considerable length 
in the Wester^ Lancet, and his views were at least partially endorsed 
by the Editor of that Journal. Dr. Annan contended that the Conven- 
tion was not properly a National one, because some Sections of the 
country were represented very imperfectly, and many of the Colleges 
not at all ; and hence its reconimendations, were not binding either on 
the profession or the Medical schools. He not only opposed the exten- 
sion of the Lecture term in the Colleges to six months, as recommended 
by the Convention, but he opposed still more strenuously the resolutions 
adopted, setting forth a standard of preliminary education to be required 
before commencing the study of medicine. 

Those resolutions were contained in the article published in the April 
number of this Journal. The standard requires simply, that the indi- 
vidual proposing to study medicine, shall have u acquired a good En° 
32 



246 Original Communications. [June, 

glish education, a knowledge of Natural Philosophy and the elementary 
Mathematical Sciences, including Geometry and Algebra ; and such an 
acquaintance at least with the Latin and Greek languages as will ena- 
ble him to appreciate the technical language of medicine, and read and 
write prescriptions." 

And yet Dr. Annan gravely and at considerable length, contended that 
these requirements were too high ; that they impose unnecessary bur- 
dens on the student, and, if exacted, would deter many from studying 
the profession, who would otherwise enter it with profit to themselves, 
and benefit to the community. This effort of Dr. Annan, like the Ad- 
dress of Dr. Martyn Paine, previous to the first Convention, instead of 
diminishing the confidence of the profession in the doings and objects 
of those who assembled in Philadelphia, only served to call out able re- 
plies from several sources, both in the east and the west, and thereby 
direct the attention of a much larger number to the importance of the 
whole subject. Perhaps the most important of these replies was that of 
Dr. Sutton, of Georgetown, Kentucky, published in the Western Jour- 
nal of Medicine and Surgery. He refuted all the special pleading of 
Prof. Annan, with sound arguments and happy illustrations. But while 
some of the resolutions adopted by the Philadelphia Convention were 
objected to by such Journals as were connected with the Medical Col- 
leges, they were almost unanimously approved by the great mass of ac- 
tive practitioners, as represented in the several State and County or 
District Societies. Indeed, one of the earliest and most important re- 
sults which followed the organization of a permanent National Associa- 
tion, was the organization of new Societies and Associations in states 
where none existed before, and the revival of many old Societies which 
had ceased to maintain an active existence. 

During the period intervening between the sitting of the Convention 
in Philadelphia, and the next annual meeting in Baltimore, new State 
Medical Societies were organized in South Carolina, Alabama, and 
Pennsylvania ; and the old ones were greatly invigorated in Georgia, 
Mississippi, Tennessee, Ohio, and Wisconsin. In all these and many 
others in the Middle and New England States, resolutions were adopted 
cordially sanctioning the action of the National Convention, particular- 
ly in reference to the subject of preliminary and medical education. The 
following resolutions adopted by the Medical Society of the State of De- 
laware, at its Annual meeting in December 184.7, will afford a fair re- 
presentation of the action of nearly all the State Medical Societies in 
the United States, in reference to the same subject. 



1854.] American Medical Association. 247 

" Resolved, That this Society regard the unanimity which character- 
ized the proceedings of the National Medical Convention, at its annual 
meeting in May last, and the prospective field of action then unfolded, 
as sources of gratification, and as calculated to advance the best interests 
of the medical profession, and of the community at' large, by elevating 
the standard of medical education and ethics, and by exciting a spirit of 
scientific investigation throughout the Union." 

" Resolved, That this Society coincide in the recommendation of the 
Convention, as respects preliminary education, the requirement of the 
medical schools, and registration of births, marriages and deaths ; and 
that its efforts shall be directed to the advancement of the objects there- 
in contemplated/ ' 

But while the proceedings of the great National Medical Congress at 
Philadelphia, were thus explicitly ratified and sanctioned by the great 
body of American practitioners, as represented in the state and local Soci- 
eties, it is evident that most of those directly connected with the medi- 
cal schools, looked upon the whole movement with distrust, chiefly, how- 
ever, on account of the proposed extension of the Lecture term to six 
months. That they felt strongly the moral force of the recommenda- 
tion, was evident both from the comments of such Medical Journals as 
represented particular schools, and from attempts to partially comply 
with the requisition. Thus the medical department of the University 
of Pennsylvania promptly extended its Lecture term to six months, 
thereby complying with the recommendation in full; the College of 
Physicians and Surgeons, the oldest and most influential school in New 
York, extended its term to five months ; while most of the remaining 
schools contented themselves with the addition of from two to four weeks 
of preliminary instruction, on which their classes might attend or not, 
as they chose. 

Such seems to have been the immediate and obvious influence produ- 
ced by the organization of the American Medical Association, and the 
two National Conventions that preceded it. 

The first regular annual meeting of the Association commenced its 
session on the 2d day of May, 1848, in the city of Baltimore. At 11 
o'clock A. M., the President, the venerable Dr. Nathaniel Chapman of 
Philadelphia, took the chair and opened the session with a very brief, 
but eloquent and appropriate address. In applying the word appropri- 
ate, to the remarks of Dr. Chapman, I do not wish to be understood aa 
endorsing fully one of the prominent sentiments then uttered by him, 
and which reads as follows, viz : " The profession to which we belong, 



248 Original Communications, [June* 

once venerated on account of its antiquity — its varied and profound sci- 
ence—its elegant literature — its polite accomplishments — its virtues-— • 
has become corrupt, and degenerate to the forfeiture of its social position, 
and with it, of the homage it formerly received spontaneously and uni- 
versally." It would be exceedingly gratifying to know when was that 
golden period in the history of medicine, characterized by profound sci- 
ence and elegant literature, coupled with the polite accomplishments anc\ 
exalted virtues of its votaries. 

It could not have been at a very ancient period, for with the excepr 
tion of here and there a brilliant star in the medical firmament, we find, 
in all the earlier centuries, instead of profound medical science, only a 
medicaj literature corrupted by an intermixture of all the mythological, 
alchemistical, and superstitious dogmas of the times, indeed, Dr. Chap- 
man himself, in the same brief address, tells us that, " with the present 
century the spirit of philosophy began to be infused into it, (medicine) 
Creative of real and substantial improvements in its theories and modes, 
of practice, raising it from a low and conjectural art, to a place among 
the legitimate sciences." The present century commenced with the year 
1800 ; and if with that began the first real infusion of the spirit of true 
philosophy into medical science and literature, resulting in their sub- 
sequent elevation to a " place among the legitimate sciences/' then sure- 
ly, we must search for the golden age alluded to, among the records of 
the last fifty years ; that is, within a period covered by the professional 
career of Dr. Chapman himself. Now the idea that the profession, in 
any of its aspects, has become more corrupt and degenerate during that 
brief period, will appear simply ridiculous to all who are familiar with 
its history. I know it may be said that Dr. Chapman referred more 
particularly to its u social position" than to its progress in science. The 
time has been, doubtless, when a powdered wig, a golden headed cane, 
and a pompous display of the mythological jargon of past centuries, 
elicited from the superstitious multitude, an admiring deference and 
blind homage unknown at the present day. But was that a social posi- 
tion to be desired ; or to be remembered with regret by enlightened 
minds of the nineteenth century ? I think not. And I further think, 
that we shall search the records of the past in vain, to find a period when 
the profession possessed more profound science — more elegant literature. 
— more varied accomplishments — or more exalted virtues, — than at the, 
present time. 

The idea that there has been during the last century, any period when 
the profession, has become cprrupt and degenerate, in any of its aspects, 



1854.] An\erican Medical Association. 249 

whether scientific, literary, moral, or social, is delusive and untrue. 
False pretenders and quackery have abounded in every age, from that 
of Hippocrates to the present. But legitimate medicine has advanced 
with every step of progress in general science and philosophy. And dur- 
ing the last half century, especially, has every branch of the healing art 
become enriched and expanded by an accumulation of facts and the ap- 
plication of philosophical principles of research, beyond any other period 
that can be named. It is this very rapid advance in science and litera- 
ture which has made ignorance in the profession more apparent, exposed 
more fully the tricks and arts of mere pretenders, and brought the whole 
profession more rigidly to the necessity of resting its claims to public 
confidence on its actual attainments. The real boundaries of medical 
science, the sum total of medical knowledge, has also immensely increas- 
ed, as is easily demonstrated by comparing the text-books and medical 
literature of 1800 with those of 1850. And yet with all this increase 
of medical science and literature, including the applications of the mi- 
croscope, organic chemistry, and physical means of diagnosis, the nomi- 
nal term of medical pupilage has remained the same. 

The medical schools attempt to teach the medical science of 1850, in 
the same number of weeks as they did that of 1800. Hence the real 
cause of that restlessness of the professional mind, and that demand for 
reform which resulted in the formation of the American Medical Asso- 
ciation, was not corruption and degeneracy, nor a consciousness of social 
degradation ; but it was the failure on the part of the profession at large, 
to exact of those proposing to enter its ranks, a general education, cor- 
responding with the extent and intricacy of the medical field before 
them, and an equal failure of the medical schools to extend and system- 
atize their courses of lectures in a ratio with the rapidly extending sci- 
ences which they professed to teach. 

The whole number of delegates present at the meeting in Baltimore 
was 266, representing societies and medical institutions in twenty-one 
States and the District of Columbia. After a variety of motions ancl 
some ballottings, a Committee of one from each State represented in the 
Convention, was appointed to recommend suitable candidates for ofiicers 
of the Association during the coming year. Dr. Chapman, in his opening 
address had expressly declined being a candidate for re-election, and 
urged upon the Association the propriety of adopting the principle of 
rotation in office. On the morning of the second day of the session, the 
nominating committee reported the following list of candidates, who were 
unanimously elected as the ofiicers of the Association, viz : 



250 Original Communications. [June, 

PRESIDENT, 

Dr. Alexander H. Stevens, of New York. 

VICE-PRESIDENTS, 

Drs J. C. Warren, of Mass.; Samuel Jackson, of Pennsylvania; 

Paul F. Eve, of Georgia ; W. M. Awl, of Ohio. 

SECRETARIES, 

Drs. Alfred Stille', of Philadelphia; H. Y. Bowditch, of Boston. 

TREASURER, 

Dr. Isaac Hays, of Philadelphia. 

Dr. Stevens on being conducted to the chair, returned his thanks to 
the Association for the honor conferred, and added some very excellent 
remarks. The most important subjects which engrossed the attention of 
the Association during the session, were embodied in the reports of the 
Standing Committees appointed at the meeting in Philadelphia. The 
report on Medical Sciences was made by Dr. W T. Wragg, of Charles- 
ton, S. C. ; that on Practical Medicine by Dr. Joseph M. Smith, of New 
York, to which was appended a very interesting paper on (Edematous 
Laryngitis, by Dr. Gurdon Buck, one of the Surgeons to the New York 
Hospital ; and that on Obstetrics, by Dr. Harvey Lindsly, of Washing- 
ton, D. C. These several reports were well written, and contained a very 
full resume of the recent improvements made in these important depart- 
ments of medical science. The report on Surgery was made by Dr. George 
"VY. Norris, of Philadelphia, to which was appended three papers on 
anaesthetic agents in surgical practice, namely, one by Dr. Isaac Parrish 
of Philadelphia, one by Dr. Henry J. Bigelow of Boston, and one by Dr. 
R. D. Mussey, of Cincinnati. These last named papers led to a somewhat 
protracted and very interesting discussion, during which much valuable 
information in relation to the use of Ether, Chloroform, and Chloric 
Ether, was communicated, by Dr. J. C. Warren and others. 

The report from the Standing Committee on Medical Literature was 
made by Dr. Oliver Wendell Holmes, of Boston; and that on Medical 
Education, by Dr. A. H. Stevens, of New York. The latter report was 
accompanied by a series of resolutions, declaring it to be the duty of the 
Trustees of Hospitals to open their wards for the purposes of clinical 
instruction; that every system of medical instruction should rest on the 
basis of practical demonstration and clinical teaching, and that Medical 
Colleges should gain access for their students to the wards of a well regu- 
lated hospital ; that no mere political considerations should influence the 
appointment of those who are to serve as Hospital Physicians and Sur-. 



1854.] American Medical Association. 251 

geons; that the recommendations of the Convention of May 1847, in 
relation to preliminary education and the requisites for graduation, be re- 
affirmed by the Association ; and some other items of less importance. 
These resolutions were discussed fully in Committee of the whole, and 
finally adopted with one or two amendments. The resolution in relation 
to preliminary education, &c, as adopted, is as follows, viz : 

" Resolved, That this Committee reiterate and strongly recommend 
to the Association a practical observance of the resolutions appended to 
the report of the Committee on preliminary Education, and on the re* 
quisites for graduation submitted to the Medical Convention which as- 
sembled in Philadelphia in May, 1847." 

The foregoing reports from Standing Committees, occupy 240 pages 
of the volume of Transactions, and are well worthy of the perusal of 
every member of the profession. The paper of Dr. Buck on (Edematous 
Laryngitis and the practicability of scarifying the glottis, was illustrated 
by several well executed colored plates, and is alone worth the cost of 
the whole volume. 

The report of Dr. Holmes on Medical Literature criticises with seve- 
rity, the proneness of American writers to content themselves with the 
position of Editors of Foreign works ; and with still greater severity the 
character of some departments of our medical periodicals. But he closes 
his report without any more specific recommendations than the following, 
viz : a It is by indirect means rather than by direct contrivances that this 
desirable object, (the improvement of our medical literature,) is to be 
promoted; by elevating the standard of education; by the stern ex- 
clusion of unworthy articles from Medical Journals ; by the substitution 
of original for parasitical authorship ; and by introducing such a tone of 
general scholarship and scientific cultivation, that the finer class of in* 
tellects may be drawn towards the ranks of the medical profession." 

During the session of the Association, a communication was received 
from the Medical Department of the National Institute in reference to 
the Sanitary condition of the United States, informing the Association 
that a Committee had been appointed on that important subject, and in- 
viting its aid and co-operation. 

This was responded to by the Association, and a Committee, consist- 
ing of twelve eminent members of the profession was appointed to report 
on the subject at the next annual meeting. 

Dr. T. 0. Edwards, then a member of Congress from Ohio, made a 
very interesting communication to the Association on the subject of the 
adulteration of imported drugs, and the necessity of a law of Congress, 



252 Original Communications. [June, 

requiring the inspection of drugs in all the principal sea-port towns. 
The communication of Dr. Edwards was received with attention, and 
published in the Transactions of the Association. A formal memorial 
for such a law as had been proposed, was drawn up and presented to 
Congress. A report occupying seventeen pages of the volume of Trans- 
actions, was made by the Chairman of the Committee on Indigenous 
Medical Botany, Dr. N. S. Davis, of New York. This report was chiefly 
occupied with the discussion of the medicinal properties of the Rumex, or 
Water Dock ; the Lycopus Virginicus ; the Hamamelis Virginicus ; 
and the Cimicifuga Kacemosa. It seems to have been the design of the 
Chairman of this Committee, to institute a thorough inquiry into the 
real medicinal properties of such native plants as had been reputed to 
possess valuable medicinal qualities, rather than the collection of mere 
Botanical Catalogues. And it is to be regretted that his design has not 
been fully carried out, for there is no subject that more imperiously 
demands a thorough investigation than this. This report was de- 
signed by its author, merely as the beginning of a work, that would re- 
quire years to complete. It was accompanied by two papers embodying 
extensive Botanical Catalogues of Medicinal Plants, one from Dr. Ste- 
phen W. Williams, of Massachusetts, and the other from Dr. F. P. Por- 
cher, of S. C. These were returned to the Committee with the request 
that their investigations should be continued another year. On motion of 
Dr. Corbin, of Virginia, delegates were appointed to visit and exchange 
friendly intercourse with the British and Provincial Medical and Surgi- 
cal Associations. Drs. George B. Wood, Jacob Bigelow, and H. H. 
McGluire were appointed for that purpose. Various amendments to the 
constitution were proposed, but could not be acted upon until the next 
annual meeting of the Association. 

The number of Standing Committees required by the Constitution' 
was appointed , and the City of Boston selected as the place for the next 
annual meeting. With the exception of a few items of discord at the 
commencement of the session, the proceedings of this meeting were con- 
ducted throughout; with much harmony and good feeling. The session 
was continued three days, and evidently contributed much to increase 
the confidence of the profession in the permanency and value of the As- 
sociation. It was evident that an active spirit of improvement had been 
aroused in every department of the profession. 

It was manifest in the rapidly increasing social organization of the 
profession, to which I have already alluded. It was equally manifest 
in the zeal with which the several Committees appointed by the Associ- 



1854.] Verdeil — Acid Secreted in the Lungs. 253 

ation, entered upon the literary labors imposed upon them ; and still 
more by the disposition to communicate valuable private papers, like 
those of Drs. Buck, Du Bois, and Edwards, which were presented at the 
present session. 

And as the first regular annual session of the Association closed, I 
think every member felt willing to unite heartily in the following senti- 
ment which constituted the closing remark of Dr. Stevens on taking the 
presidential chair. 

" Our Association stands forth without a parallel in its high purposes, 
and in its means of accomplishing them. May it prove an exemplar of 
similar organizations in our sister republics of the Western Hemisphere, 
and exhibit in a new form to our brethren in Europe, the easy adapta- 
tion of our institutions to the great end of promoting the happiness of 
mankind. " 



On a peculiar Acid, secreted in the Lungs. By Dr. Verdeil, ( Comptes 
Rendus.) Translated for the N. J. Medical Reporter, by Ch. F. J. 
Lehlbach, from the German (Medicinische Neuigkeiten ; Erlangen : 
vol. ii. p. 160. Edited by Prof. Wintrich). 

" Verdeil has examined the lungs of many animals, and is most evi- 
dently convinced, that in the parenchyma of the lungs, a peculiar crys- 
tallizable acid is present, which forms crystalline compounds with bases. 
This acid is partly in a free state, but preponderates as a salt of soda. 
Verdeil experimented in the following manner : He cut up the pulmo- 
nary tissue into excessively small slices, so as to render it almost of a 
pasty consistence. He then triturated the mass with cold distilled wa^ 
ter, placed it in a linen sack and expressed the liquid. This mani- 
fested an acid re-action. The liquid was then heated in a sand bath, to 
separate the albumen by coagulation ; then it was neutralized by baryta, 
and evaporated in the water-bath to about three-fourths of its former 
volume. Then a solution of sulphate of copper was added, which pro- 
duced a thick and copious precipitate. The liquid haying again been fil- 
tered, was found to contain sulphate of copper in excess. Dr. Verdeil 
then added a small quantity of sulphuret of barium in solution, so as to 
produce an insoluble salt of sulphate of baryta and sulphate of copper. 
The supernatant liquor was again filtered and evaporated until crystals 
of sulphate of soda commenced to form. As soon as this took place a 
little diluted sulphuric acid was added, and the liquid treated with boil- 
ing rectified alcohol. By this process, the pulmonic acid is dissolved, 
oo 



254 Original Communications. [June, 

while the sulphate of soda remains behind insoluble. During the cool- 
ing of the alcohol, in the course of a few hours, needle-like crystals form, 
around a centre, which can easily be seen adhering to the sides of the 
vessel. 

This crystallized, pulmonic acid is lustrous, has a considerable light-, 
reflecting power, and loses no water of crystallization, if heated to 100 
deg. R. It is easily dissolved in water, but insoluble in ether and alco- 
hol, soluble, however, in boiling alcohol. The elementary analysis 
showed it to consist of carbon, hydrogen, nitrogen, oxygen and sulphur. 
(An accurate chemical formula has not yet been obtained.) This acid 
has the property to disengage carbonic acid from carbonates. It seems 
to play an important part in the animal economy, decomposing , as it 
seems, the carbonate of soda, carried in the blood to the lung, by combi- 
ning with the soda, and in this way setting the carbonic acid free. 

That this acid is secreted in a free state by the lungs is proved by 
the fact, that all blood has an alkaline re-action. The pulmonic acid 
combining with the soda of the blood, does not change the chemical re- 
action of the latter, because it only takes the place of the expelled car- 
bonic acid." 

Remarks by the Translator. — It was formerly believed, that the car- 
bonic acid, which we exhale, was formed in the lungs. The opinion 
prevailed, that the blood which is sent to the lungs through the arteria 
pulmonalis, carried carbon with it, and that the oxygen which we in- 
spire entered in the lungs directly in combination with this carbon, so 
%s to form carbonic acid in such a way, that the oxygen taken in by 
one inspiration would again be expelled in the form of carbonic acid gas 
with the next expiration. But this theory has been abandoned by all 
physiologists, since it is known, not only that the oxygen, taken in the 
lungs, is carried by the red corpuscles to every part of the body, but 
also, that carbonic acid is found to be ready formed in the venous blood. 

Modern physiology also leaves no doubt as to the source of carbonic 
acid. It is formed in the capillaries, The only question which remain- 
ed an open one is, in which state does the carbonic acid reach the lungs? 
Manifold experiments on the absorption of gases by different fluids, 
leave no trace of a doubt, that a part of the carbonic acid is absorbed in 
a free state by the venous blood. But taking into consideration the 
large amount of carbonic acid daily exhaled by the skin, it seems proba- 
ble, that this free carbonic acid is removed through this channel. The 
absorptive po.wer of the blood, however, in reference to carbolic acid, is 
not by any m,eans so high, that we could account in this way for the^ 



1854.] Verdeil — Acid Secreted in the Lungs. £55 

whole mass of carbonic acid expelled from the lungs. The theory, that 
carbonic acid reaches the lungs in combination with alkalies, so as to 
form carbonates, has not hitherto been accepted, on the ground that 
it could not be explained how the carbonic acid could be separated in 
the lungs from such a base, and set free. The discovery of a peculiar 
pulmonic acid by Dr. Verdeil, has removed all objections, formerly in 
the way of this theory. 

If we take into consideration the objects of respiration, we find them 
to be twofold. The first object of the respiratory process is, to carry 
oxygen into the system. The oxygen is not mechanically absorbed by the 
blood, but in the lungs it enters into a chemical combination with the 
haematin of the red corpuscles. Iron forms an essential constituent of 
hsematin. In chlorosis it is substantially iron, which is wanting in the 
formation of red corpuscles, and because we find in this disease an in- 
sufficient oxygenation of the blood, we are justified to conclude, that 
the iron of the hozmatin unites chemically with the oxygen and sets it 
free in its course through the capillaries, wherever it is wanted for the 
processes of nutrition and re-absorption. In this manner we find iron 
to be the carrier of oxygen. 

The second object of respiration is to remove the carbonic acid f which 
has been formed in the capillaries by the decomposition of disintegrated 
tissues. Should there not be a carrier of carbonic acid for the process of 
decarbonization, as there is a carrier for that of oxygenation of the blood? 
Verdeil seems to have answered this question indirectly by accepting , 
that carbonate of soda is decomposed in the lungs, by the peculiar pul- 
monic acid discovered by him. 

In a pathological point of view, this discovery must lead to important 
results. If the secretion of the pulmonic acid is disturbed, if it is se- 
creted in an abnormally small quantity^ so as to be insufficient to decom- 
pose the normal amount of carbonate of soda, the carbonic acid is ne- 
cessarily accumulated in the organism, and in this way diseases may be 
caused, especially of the liver; The antagonism between this organ and 
the lungs, has long been observed, although the remote cause of this 
was not known. 

Disturbances of the animal organism by an abnormally increased se- 
cretion of this acid, cannot be determined before we are acquainted with 
the proportions in which the elements forming the acid are combined. 

If we accept soda to be the carrier of carbonic acid in the animal or- 
ganism, we can easily explain why common salt must be so essential a 
constituent of our food, and why we take it in larger proportions even 



256 Original Communications. [sfufcEj 

than carbonates and phosphates of lime and magnesia, which enter to a 
larger extent into the constitution of our frame than salts of soda. 

Whether in some disturbances of the process of respiration > chloride of 
sodium would not act analogous to iron in chlorosis, by supplying a ne- 
cessary element of decarbonization, as the former supplies an element of 
oxydation, is a question which remains to be settled by practical expe- 
rience in the sick chamber.* 

If further researches and experiments should either confirm or over- 
throw the remarks and suggestions made by the translator, he will re- 
turn to the subject, if it has not been done by somebody else before him. 



Chloride of Sodium in Intermittent Fever.- 

By Edward D. G. Smith, M. D. 

Every one who has treated Intermittent Fever to any extent, has 
been annoyed by the obstinacy with which it sometimes resists all mea- 
sures which are brought to bear upon it ; and will be prepared to wel- 
come what appears to be a new remedy. For though Chloride of Sodium 
has long been used in medicine for various purposes, — emetic^ alterative, 
astringent, anthelmintic^ &c<, its use as an anti-periodic, as far as I can 
discover from considerable search and enquiry, is of modern date. 
Eberle, Dewees, Watson, Wood and Gregory, in their several treatises 
upon Intermittent Fever do not mention it: neither is this property as- 
cribed to it by Peieira or the XL S. Dispensatory* The merit of first 
proposing it in this complaint, according to an article in the New Jer- 
sey Medical Reporter for December, 1851, is due to Dr. Piorry of 
Paris, who administers it in doses of two table spoonsful once or twice a 
day, and asserts that it arrests the paroxysms as promptly as quinine. 
Professor Herrick of Rush Medical College, also reports the result of 
several trials made with it, which go to corroborate the statements of 
Piorry. He prescribes it in doses of three or four drachms, twice daily 
in mucilage. After the fever is checked he gives it in smaller doses — 
ten grains with th« same quantity of carbonate of iron two or three 
times daily, as a tonic and corrective of the secretions of the alimentary 
tube. From the high terms iiit which it was spoken of by these gentlemen, 
I resolved to administer it upon the first opportunity. I did so, and the 
result was so satisfactory, that I was induced to give it a more extensive 
trial. I have given it in many cases; in some of which quinine and ar- 

* Since this was written, the writer has learned that chloride of sodium has beeri 
ttfeed with great success in intermittent fever, by Dr. E. D. G. Smith, of Newark, K. Jv 



1854.] SMITH — Chloride of Sodiurri in Intermittent Fever. 257 

senic had failed ; and its almost invariable success, I think, warrants the 
praises bestowed upon it, and entitles it to recognition among the arti- 
cles generally considered as specifics in this complaint. In fact, I do* 
not recollect a single instance in which it has failed, when it has been 
faithfully taken according to my directions; In those cases in which it 
has appeared to fail, I have found, upon strict enquiry, that the patient 
neglected to take it, — generally because of its nauseous taste ; which un- 
fortunately cannot be entirely hidden, and which is the principal objec- 
tion to its use, especially for children. I think there is less tendency 
to the return of the disease at the expiration of the week, when cured 
by the chloride, than when quinine or arsenic is used. My friends, 
Drs. Eyrich and L. Gr. Thomas, who have both given it successfully im 
many cases, are of the same opinion. 

I found the doses directed by Drs. Piorry and Herrick rather too 
large ; — in most instances the stomach being unable to retain them. My 
method, therefore, has been to give it, during the interval of the fever, 
in doses of a teaspoonful — in weight from 3jss to gij., in slippery elm 
or toast tea, every three hours for five or six times ; — after thoroughly 
clearing out the alimentary canal by Calomel and Jalap or the Bilious 
Pills. Indeed, these doses have in many instances, caused vomiting at 
first ; especially if there was much gastric derangement :- — but tolerance 
was generally soon established, and the vomiting ceased after the first or 
second dose, having undoubtedly done much good by clearing out the 
stomach. In a few cases, however, the medicine continued to cause 
vomiting at every dose, and I was obliged to discontinue it and resort 
to quinine or arsenic in its stead. 

As some patients would doubtless object to " Common Salt" in its 
natural state, it occurred to me that it would be well to disguise it j 
which I have been in the habit of doing by rubbing it up with Red 
Saunders, thus making it of a fine pink color, and then adding a few 
drops of oil of anise. This deception has been successful. I have fre- 
quently been amused by comments upon, and questions as to the cause 
of its " saltish taste." The information that the taste was the result of 
the manner in which the medicine was prepared, has always been satis- 
factory ; — no suspicions as to its real character, having, as far as I am 
aware, been entertained after this explanation. , 

The first patient to whom I administered the chloride was an old 
Irish woman of about 60, who had been afflicted with a tertian fever 
for some two months, and said she had taken quinine nearly every day 
eince she had been sick : — a statement which I received with some al- 



258 Original Communications. [June* 

lowance. She was in a very desponding frame of niind, and said she 
knew she was going to die, and all she wanted of the doctor was to give 
her a line to the priest, who refused to come to her spiritual aid with- 
out such a testimonial. I endeavored to encourage her, and induce her to 
make one more effort before abandoning herself to despair; assuring her 
that if I found she could not be cured, I would give her the desired 
epistle in time to secure her salvation before she died. After some 
persuasion she consented, and after the operation of a dose of bilious 
pills, which she took at bed-time, she commenced the next morning — 
it being her well day — with the chloride, in doses of a teaspoQnful in 
toast tea, every three hours, with orders to soak her feet in hot water 1 
the next day, before the time when the paroxysm generally came on, 
and to remain warmly covered up in bed during the day. She compli- 
ed faithfully with my directions, though as she afterwards informed me, 
rather to secure the line to the priest, which I had refused to give her 
otherwise, than from any great faith in the medicine. To her and my 
great delight, she had not another paroxysm; and I saw her again a 
month or two afterwards, when she told me she had not been sick a 
moment since she took the medicine, in praise of which she was elo- 
quent. In fact, she had improved wonderfully in appearance and also 
in spirits : all of which improvement she ascribed to the chloride. 

Her grand-daughter, a girl of 17 or 18, was afterwards attacked by 
the fever, also of the tertian type, and the old lady requested me to give 
her some of the same medicine. I accordingly left her a dose, to be 
preceded, as in the case of the grandmother, by three bilious pills over 
night. She took the pills (which operated thoroughly) and placed the 
powder under her pillow, where it remained when I visited her the next 
day, which was her well day. She and the old lady were both fully 
convinced that she was cured by having the medicine under her pillow, 
and I could not persuade her that it would be necessary to take it that 
day. But unfortunately for the reputation of the chloride as a worker 
of miracles, this marvellous cure did not prove to be permanent,— the 
fever returning at its regular time the next day. It however, eventual- 
ly yielded to the internal exhibition of the remedy, in which the confi- 
dence of all parties, especially myself — remained undiminished by the 
first failure. In fact, in every case in which I have administered it, my 
confidence in its virtues has been increased : the only instances in which 
it was at all shaken, which only occurred in my earlier experiments^ 
being those cases of apparent failure already mentioned. I think, there- 
fore, that it ie not claiming too much for it to rank it with quinine and 



1854.] Proceeding* of Medical Societies. 259 

arsenic, the remedies most used in intermittent fever ; and it possesses 
some advantages over either. It may be used more freely than either. 
It never causes the fulness of the head, and deafness which quinine 
sometimes does, especially when given in large doses : — or the gastric 
derangement, oedema, &c, which occasionally arise from the use of arse- 
nic. It is certainly true that both of these are perfectly safe when 
properly used. The chloride has also the merit of cheapness, which is a 
recommendation, especially when the medicine, as so frequently hap- 
pens, is to be given away. 

As the chloride has so marked an influence over intermittent fever, 
it would be well to try its effects in the analogous disease, neuralgia, 
and I intend doing so when a fitting opportunity presents. My expe- 
rience with it thus far in this complaint, is of rather a negative charac- 
ter. I gave it to a woman for whom I had frequently prescribed, for 
tic-doloreux, and told her if it did not cure her to come to me again, 
which she promised to do, and I think would have done if she had not 
been cured ; as she was always troubling me before. I never saw her 
again. However, I will leave others to draw the inference. 

Newark, April, 25, 1854. 



PROCEEDINGS OF MEDICAL SOCIETIES. 



Mereer County, N. J. — The District Medical Society for the County of Mercer met 
on the 18th of April, in Trenton, at the Temperance Hall. Dr. Woolverton presided. 
This being the annual meeting, the officers elected for the ensuing year were — 

President, - Dr. Phillips of Trenton. 

Vice Presidtnt, " McKelway, 

Secretary, • " Johnston, 

Treasurer, • " Quick, 

Reporter, • " Rob$ins, of Hamilton. 

Dr. Coleman produced a written communication to prove that miasma is the re«. 
suit of disease in living vegetables, and that it is not produced by the decomposition 
of dead vegetable matter. It stated that the destructive decomposition of dead or- 
ganic forms, whether animal or vegetable, resulted in known compounds, which are 
not regarded as poisons. That the vital processes, changed by disease, frequently 
generate in animals the most destructive agents. Analogy, it was maintained, would 
warrant the conclusion, that vitiated vegetable functions may evolve those subtle and 
deleterious influences, which all experience teaches, arise from situations where liv- 
ing plants, by alternation of wet and dry, shade and sun, are suffering decay. 

This paper gave rise to considerable discussion, in which most of the members 
took part* 

The subject proposed for conversation at the next meeting, was " Disturbance of the 
nerve function." A discussion arose on the choice of subject. Some members 
thought the diseases of the season, (July), would be of more practical advantage, 



26Q Original Communications. [June, 

Dysentery was named. This was objected to, as requiring too little investigation, 
presenting nothing new, being the subject of one third of the theses written for grad- 
uation, and a disease every where discussed. A subject that embraced more, that 
must be regarded in the investigation of every perverted function, and the neglect of 
which, is mainly the cause of the regular practitioners being over-reached by the dif- 
ferent varieties of pretenders, was urged as more fitting the Society. Under these 
views it was adopted. 

Dr. Woolverton was elected Essayist for the next meeting. 

A resolution was passed, recommending the New Jersey Medical Society to hold 
a Special Meeting in May or June next. The Society considered the amount of un- 
finished business, and alterations in the medical laws of the State, made during the 
last session of the Legislature without the knowledge of the State Society, of sufficient 
Importance to require a meeting. 



Somerset County, TV. J. — The District Medical Society of the County of Somerset, 
held its annual meeting at Somerville, April 27th, 1854. Dr. F. S. Schenck presided. 

After the usual preliminary business, Dr. L. H. Mosher signed the Constitution, and 
was received as a Fellow of the Society. 

Dr. J. W. Craig read an interesting report of an epidemic of erysipelas, occurring 
in the vicinity of Plainfield during last February. The disease assumed a malignant 
form, and proved fatal in five cases. The account was the more interesting to the 
Society as epidemic erysipelas is almost unknown among us. 

Dr. F. F. Van Derveer read the history of a case of con vu lsions, accompanied with all 
the symptoms of the first and second stages of Hydrocephalus, which terminated fa- 
vorably by an abundant discharge of pus from the nostrils. 

After attending to the usual reports, &c, the following officers were chosen for the 
ensuing year. 

President, - - Ferdinand F. Schenck, 

Vice President, - C. C. Suydam, 

Corresponding Secretary, J. W. Craig, 
Recording Secretary, H. F. Van Derveer, 

Treasurer, - - A. Skillman. 

Drs. Mosher, Martin, H. F. Van Derveer, and Grey, were chosen delegates to the 
State Society. 

Published by order of the Society. H. F- VAN DERVEER, Sec. 

Essex County, TV. J.-^The District Medical Society for the County of Essex, met 
at the City Hotel, Newark. Dr. A. N. Dougherty, the President, delivered an ad- 
dress on the connection between Literature and Medicine in the 17th century. He 
reviewed briefly the progress of medicine, from the beginning of the art up to that 
time, and showed from quotations from their writings the influences which the theo- 
ries of medicine, then in vogue, had upon Massinger, Shakespeare, Butler, and Mo- 
liere. The theories of Paracelus, "the prince of quacks," and founder of the chemi- 
cal school, who pretended to be able to give immortality by the elixir vitae, but died 
at an early age a drunkard, so that it is supposed his eiixir was some excellent kind 
of liquor, — and the opposite theory of Galen, the founder of the botanical school, were 
those which ruled the age. Many amusing quotations were given from the authors 
named, and the whole address was peculiarly unique and interesting. 

Dr. E. D. G. Smith read an essay on the use of Chloride of Sodium in intermittent 



1854.] Proceedings of Medical Societies. 261 

fever. This practice has been recently recommended by a Parisian physician as a 
substitute for quinine and arsenic, and Dr. Smith concludes from his experience with 
it, that it can be used efficaciously. The French Government having offered a re- 
ward for a cheaper specific than quinine, Dr. Piorry experimented with this, and arri- 
ved at satisfactory conclusions. The essay, though brief, was regarded favorably, 
and elicited attentive consideration. 

Dr. Eyrich read an essay on Digitalis and Tartrate of Potass. 

Drs. Wells, Elliott and Elmer, were admitted as members of the Society. 

The following officers for the ensuing year were elected : 

President, • Dr. L. A. Smith, 
Vice Presidnnt, " J. S. Crane, 
Treasurer, - " William M. Brown, 

Secretary, • " William T. Mercer, 

Librarian, - " J. F. Ward. 

Delegates to State Society. — Drs. E. D. G. Smith, Eyrich, Dougherty, and Elmer. 

Delegate to National Medical Association. — Dr. George R. Chetwood. 

Reporter. — Dr. William M. Whitehead. 

Essayists- — Drs. Wells and William Pierson, Jr. [Daily Advertiser. 

Warren County, N. J".— The District Medical Society for the County of Warren 
held its annual meeting in Belvidere, on the 25th of April. The attendance was quite 
full, and the members of the faculty seemed to be in excellent spirits and to feel that 
the occasion was one of interest. 

The following is a complete list of members : — William P. Clark, James C. Fitch, R. 
Byington, H. Hughes, William Cole, Dewitt C. Wilson, Lewis C. Cook, P. F. Brake- 
ley, S. S. Clark, James D. Dewitt, G. H. Cline, John C. Johnson, William Kennedy, 
John S. Cook, P. F. Hulshizer. 

The following are the officers elected for the ensuing year:— ■ 

President, • William P. Clark, 
Vice President, James C. Fitch, 
Secretary, - P. F. Brakeley, 
Treasurer, - R. Byington. 
Delegates to the Medical Society of New Jersey. — *S. S. Clark, John L. Cook, P. F. Hul- 
shizer, William Kennedy. 

Delegate to the American, Medical Association. — P. F. Brakeley. 
P. F. Hulshizer was appointed to deliver the Address at the next annual meeting. 
— Belvidere Intelligencer. 

Litchfield County, Connecticut. — The annual meeting of the Litchfield County 
Medical Society, was held at the Mansion House, Litchfield, April 27th, 1854. 

Samuel T. Salisbury, M. D., President. George Seymour, M. D., Secretary. 

Minutes of proceedings of last meeting read and approved. 

Drs. Beckwith and Bostwick appointed Committee to invite Clergymen to dine 
with the Society. 

Drs. Henry M. Knight, William J. Burge, Gaylord B. Miller, J. H. T. Cockey and 
John W. Bidwell, were admitted members of the Society. William Knight was 
elected to attend the gratuitous course of Lectures at Yale College. 

Eben H. Moore was recommended to the State Convention to fill any vacancy 
which may occur in other counties for the gratuitous course of Lectures. 

Drs. William Welch, Ralph Deming, John W. Bidwell, J. W. Phelps, and A. H. 
Huxley, were elected Fellows to the State Convention. 

34 



262 Original Communications. [June, 

Drs. William W. Welch, Samuel W. Gold, Josiah G. Beckwith, Samuel T. Salis- 
bury, and James Welch, were elected Delegates to the National Medical Convention, 
to be holden in 1855, and Drs. A. H. Huxley, John Welch, George Seymour, William 
Woodruff and Manly Peters, were appointed Substitutes. 

Drs. George Seymour, Benjamin Welch, Samuel T. Salisbury, D. E. Bostwick, and 
William W. Welch, were appointed a oommittee to prepare and report a tariff of 
fees. 

The following were elected officers for the ensuing year. 
Sydney H. Lyman, M. D., President. 
William W. Welch, M. D., Vice President. 
George Seymour, M. D., Clerk. 

The President on leaving the Chair delivered the annual address. 

Voted, That the thanks of the Society be tendered to Dr. Salisbury for his interest- 
ing address, and also for the able and impartial manner in which he has discharged 
the duties of his office. 

Voted, That the Clerk prepare an abstract of the proceedings of this Convention, 
and publish it in the newspapers of the County. 

Adjourned sine die. \ldtchjield Enquirer. 



BIOGRAPHY. 



Biographical Sketch of Alexander H. Stevens, M. D., LL. D. } Second President 
of the American Medical Association. 

Dr. Stevens was born in the City of New York, September 4, 1789. 
His father, Ebenezer Stevens, was one of those who threw the Tea into 
Boston harbour. He entered the Army early, and served to the close 
of the war, Was at the battles of Saratoga and Yorktown, with the 
rank of Col. of < Artillery. After the war Col. Stevens married a sister 
of Col. Ledyard, who fell at G-roton. She was aunt to Ledyard, the tra- 
veller. 

At the age of ten years, Alexander was sent to School at Plainfield, 
where he fitted for College, under the now venerable John Adams. At 
fourteen he entered Yale College, and graduated with credit in his eigh- 
teenth year. Having selected the profession to which he has since 
done so much honor, he entered the office of Dr. Edward Miller, and 
after attending one course of lectures in the College of Physicians 
and Surgeons, and a second in the University of Pennsylvania, he grad- 
uated at the latter institution, on which occasion his Thesis " On the 
proximate cause of Inflammation," was highly lauded by Dr. Rush. In 
1811, Dr. Stevens sailed for France, but was captured by an English 
cruiser, and sent to Plymouth. Thence he found his way to London, 
and attended the Lectures of Cooper and Abernethy. Next year he 
crossed the channel, and at Paris followed the cliniques of Boyer and 



4854.] Biography. ?63 

Larrey. War meanwhile broke out between the United States and En- 
gland, and Dr. Stevens was again captured on his way to America and 
sent to Plymouth. Ultimately, he returned home in a cartel, and was 
appointed Surgeon in the Army. In 1814, he was chosen Professor of 
Surgery in the New York Medical Institution, and in 1818 elected 
Surgeon to the New York Hospital. Here he immediately began to 
give Clinical Lectures, which he continued with great success for twen- 
ty years. On the resignation of the Faculty of the College of Physi- 
cians in 1825, Dr. Stevens was appointed Professor of Surgery in that 
institution. Here, and at the New York Hospital he continued to teach 
Surgery with great acceptance till 1838, when, on account of ill health 
he resigned both places, having previously confined his practice to con- 
sultations and Surgical operations. The retirement of Dr. Stevens from 
the active duties of his profession was matter of great regret to his 
friends, and the officers of the two Institutions which he has so ably 
served, hastened to manifest their sense of the value of those services. 
He was appointed by the Regents, Emeritus Professor of Surgery, and 
by the Governor, Consulting Surgeon to the New York Hospital. His 
pupils also placed his portrait in the Governor's Room at the Hospital. 
In 1841, the Regents appointed Dr. Stevens President of the College of 
Physicians and Surgeons, an office he still holds. In 1846 he was elect- 
ed President of the New York State Medical Society, and his inaugural 
Address was ordered by both Houses of the Legislature, and by emi- 
nent members of the Bar, to be printed. About the same time he re- 
ceived from the Regents the degree of LL. D. In 1847, he was elected 
Vice President, and in 1848, President of the American Medical Asso- 
ciation. He has been present at most of the subsequent meetings of the 
Association, always ready to exercise that large measure of influence 
which his character has secured, in advancing the profession in general 
and technical learning, in Ethics and in social position,. In his own 
city, and among those brethren who have known him longest and most 
intimately, he holds a position and wields an influence which nothing 
but eminent ability could have attained, and nothing but strict integri- 
ty and inflexible adherence to honor and duty could retain. Dr. Ste- 
vens' publications have been few, and are scattered through the medical 
periodicals of the last twenty years. As a surgeon he seems not to have 
sought the reputation of an Operator, but rather to have cultivated a 
thorough knowledge of the nature and treatment of Surgical Diseases — 
content to cure while others sought to cut. 



264 Bibliographical Notices. [June, 



BIBLIOGRAPHICAL NOTICES. 



Since our last issue the death of Dr. Patterson, who was connected 
directly with this part of our work, has caused a blank, which we feel 
it difficult to supply. We have on hand, however, a few works for no- 
tice, which must lie on the table another month, for want of space in 
our present number to do them justice. We will name them merely 
now, with our acknowledgments to the publishers. 

Hand Book of Chemistry, Theoretical Practical, and Techni- 
cal. By F. A. Abel, Professor of Chemistry, &c, &c, &c, and by 
C. L. Bloxam, formerly first assistant to the Royal College of Che- 
mistry, with a preface by Dr. Hofmann, and numerous illustrations in 
wood. 

Woman ; her Diseases and Remedies. A series of Letters to his 
Class, by Charles D. Meigs, M. D., Professor of Midwifery, &c, &c. 

The Science and Art of Surgery. Being a Treatise on Surgical 
Injuries, Diseases, and Operations, by John Erichsen, Professor of 
Surgery in University College, &c, &c. Edited by John H. Brin- 
TON, M. D. Illustrated with 311 engravings on wood. 

The above are all from the house of Blanchard and Lea, Philadelphia. 

Remarks on some Fossil Impressions in the Sandstone Rocks 
of Connecticut River. By John C. Warren, M. D., &c, Bos- 
ton : Ticknor & Fields. From the Author. 



1854.] Editorial. 265 



EDITORIAL. 



AMERICAN MEDICAL ASSOCIATION. 

This body lield its eighth Annual meeting in St. Louis, May 
2 — 4. A full, complete, and reliable report of its proceedings, prepared 
specially for the New Jersey Medical Reporter, under the supervi- 
sion of the Secretary of the Association, occupies a large portion of our 
present number. 

Having neither time or space for extended comment on the proceed- 
ings in our present number, we must reserve what we may have to say 
to another occasion. 

From the roll of members it will be seen that the gathering was large, 
particularly from the Western States. We are sorry that more of our 
Eastern brethren did not attend, as we feel sure they would have done, 
had they been fully aware of the facilities of travel, and the cheapness 
of the route. Free return tickets, it seems, were furnished to delegates 
on all the routes except the Hudson River Railroad. 

A good deal of business was transacted, and many able reports pre- 
sented, all of which were referred to the Committee of Publication, and 
will in due time be presented to us in a printed form. 

A majority of the Committee of Publication this year, are residents of 
New York. We trust they will be prompt in attending to their duties, 
and that the Transactions will speedily be placed in the hands of mem- 
bers. It has been suggested to us that in former volumes of the Trans- 
actions the minutes have been incomplete. It seems to us important 
that they should be published in full. 

The annual tax on members was reduced this year from five dollars 
to three. We hope members will bear in mind that this payment in- 
sures a copy of the Transactions, which, if not forwarded to them, can 
be had on application to the Treasurer. 

Our St. Louis brethren taxed themselves very heavily, in providing 
an elegant entertainment for the members. We are happy to announce 
the prospect of retrenchment and reform in this matter of providing ex- 
pensive dinners, as by a vote of the Association they were condemned. 
It would be desirable if all intoxicating drinks were entirely banished 
in all these re-unions of the profession, 



266 Editorial. [June, 

The minutes will satisfy our readers, that whatever may be wanting, 
there is nevertheless vitality enough in the Association to hope for great 
things from it in the future. Let the good men and true in the profes- 
sion take hold of this movement heart and soul, uninfluenced by selfish 
considerations, and it will go on and realize the most sanguine hopes of 
its projectors. A perusal of the able series of papers on the History 
of the Association, now in course of publication in this journal, will 
show how it has gone on step by step, until the little one has now be- 
come a thousand. 

The Association meets next year in Philadelphia. 



A CAPITAL SUGGESTION. 

A correspondent writes us as follows. " Would it not be a good idea to 
get some one convenient to the Records, to make out for the Reporter 
a complete history of the Medical Society of New Jersey, with sketches 
es of its presidents or other members, and a notice of all the District So- 
cieties, &c? I have never seen anything but the meager (though inter- 
esting,) notice in the pamphlet containing the Laws of the State Society." 

It would most certainly be a good idea; and we hope that this pro- 
mulgation of it will be sufficient to induce some competent individual to 
undertake the task. 

If the labor is not voluntarily assumed by some one before our next 
Annual Meeting, we hope that a competent committee will be appointed 
by the Society to take the subject in hand. 

A very readable book might be made of the history of our State Me- 
dical Society. Such a history would include some of the celebrated 
names in our political history as a State. Who will volunteer to the 
work? 

DISTRICT MEDICAL SOCIETIES. 

A correspondent from Bergen county informs us that a District Medi- 
cal Society, was recently organized in that county. We congratulate 
our Bergen friends on the event, and hope a long career of usefulness is 
before them. 

There remain three or four more counties in which Societies should be 
formed. What are Middlesex, Salem, and Cape May doing ? The phy- 
sicians of Atlantic, if not sufficiently numerous to form a Society, might 
.unite with the Society of one of her neighboring counties. 

Old Middlesex was for many years the center around which the whole 



1864.] Editorial 267 

constellation of District Societies revolved. She should not remain in- 
different to the work of progress which is going on all over the country. 

Why, when quackery is organizing her forces all around us, will not 
the friends of legitimate medicine in these counties, unfurl their banner, 
and rally to it ? 

We hope speedily to be able to record the fact that, Societies have 
been organized in every county of New Jersey. 

J^°* Secretaries of District Medical Societies are particularly requst- 
ed to forward us abstracts of the minutes of their proceedings. 



THE LATE HENRY S. PATTERSON, M. D. 

It becomes our duty to prepare a brief notice of our late associate, 
Dr. Patterson. His graphic pen has been cheerfully employed since the 
commencement of the current volume of the Reporter, in enriching 
our Bibliographical Department, with reviews and notices, that have 
been sought, and no doubt appreciated, by a large number of readers; 
and it now devolves upon us to record his death, and in doing so, to tes- 
tify to his worth as a man, and his learning as a Physician. 

He was born in Philadelphia, on the 15th of August 1815, and in 
early childhood distinguished himself among his associates, for his acti- 
vity in play, his industry in study, and his strong attachment to those 
whom he loved. His educational privileges were not so great as those 
enjoyed by some others of his day, but what he failed to possess through 
external advantages, was supplied by means of an overcoming zeal, and 
power of application, from within. Indeed, his life, to its close, was 
characterized by a deep, and strong in-dwelling principle, that seemed re- 
solved to conquer difficulties, and supplant opposition. Call it ambition, 
if we may. Ambition then was the moving spring which impelled him 
onward. Call it native power, genius, or whatever else. It urged him 
upward, made him studious, thoughtful, original, and strong in purpose- 
In pursuit of his object, he was manly, generous, and kind, to those who 
might be engaged in the same struggle, and yet with his goodness and 
generosity of heart, there was a powerful will to succeed, and if possible 
to excel. In the Spring of 1839, he received the degree of M. D. from 
the University of Pennsylvania, his private instruction having been 
conducted in the office of our honored father, the late Dr. Joseph Par- 
rish, of this city, who, in imparting the principles of medicine to his 
students, never failed to convey lessons of high-toned professional probi- 
ty and strict morality, by precept, not only, but by an example, the in- 



268 Editorial. [June, 

iluence of which is still felt in the profession, and is cherished by the 
living hundreds of his pupils, with affectionate remembrance. Patterson 
possessed it in copious measure. Retiring in disposition, amiable in 
temper, patient amid the toils and privations of professional life, he was 
scrupulous to avoid hurting the feelings or injuring the reputation of 
his professional associates, and yet keenly sensible of an attempt at ar- 
rogance, or assumption on the part of others. In the year 1843, he re- 
ceived the honorary degree of A. M., from Newark College, Delaware. 
His appointments, for a man of his years, and his scientific labors, were 
more than fall to the lot of most. Soon after graduation, he was 
chosen one of the House-Physicians of the Philadelphia Hospital, Block- 
ley, where he remained two years, preparing himself by the experience 
thus afforded, for entering the arena of public professional life. In the 
midst of a great city, the young physician, surrounded by a host of com- 
petitors in the same pursuit, and by those of position, name, wisdom, 
popularity, and eminence, may well feel bis heart to tremble with fear- 
ful agitation, as he looks into the unknown future, if not inspired as 
was he, with a deep consciousness of an up-rising genius, that 
swells his soul, and makes it strong with hope, and restless for 
victory. Not for a vain triumph over friends, or a conquest that would 
laugh at the calamity of enemies ) but for a victory over adverse circum- 
stances, and obstacles, however portentious they may be. With this 
determined spirit, the offspring of native genius; and a strong moral 
principle, the robe that covered it, did he begin his career of active life. 
May we not repeat the poet's words, and apply them here ! — 

" A noble mind, unconscious of a fault, 
No fortune's frown can bend, or smiles exalt : 
Like the firm rock that in mid-ocean, braves, 
The roar of whirlwind, and the dash of waves." 

Leaving the office, the University, the Hospital, and engaging in prac- 
tice, we find the subject of our notice, physician to the Philadelphia Dis- 
pensary. In 1843, Professor of Materia Medica in the Pensylvania 
Medical College, performing during the first year of service, the addi- 
tional duty of the Professor of Chemistry. In 1846, physician-in-chief 
to the Blockley Alms House, continuing at the same time his lectures 
at the College, and adopting while there, changes in the police of the 
Institution, which were particularly salutary to the insane, as well as 
advantageous to the general regulation of all departments. He retained 
his place in the Hospital two years, though he continued to hold his 
Professorship until the prostration of his physical powers by chronic dis- 



1854.] Editorial. 269 

ease, compelled him to relinquish his post. Upon his resignation, the 
Faculty, by a unanimous vote, made him Emeritus Professor of Materia 
Mcdica, as a mark of their esteem, and confidence. In 1852, he visited 
Europe, but without much advantage to his health ; though it afforded 
him an opportunity, which, to a mind like his, must have been grateful, 
of meeting with many distinguished persons, and of adding to his store 
of varied knowledge. In 1853, he spent the winter in Florida, but with- 
out improvement, and returned home to enjoy the solace of domestic af- 
fection for a season, to see his friends once more, still to pursue, on his 
bed of suffering, the impulses of his genius, undimmed by disease— ^un- 
tamed by pain • to scatter with his dying hand a few more trophies of a 
spirit unconquered, upon his pathway to the grave. While confined to 
his bed ,he wrote the inimitable biography of the late Dr, Samuel G-eorge 
Morton, and two critical notices of the " Types of Mankind. " One of 
these was published in the last number of this Journal. All his previous 
Bibliographical Notices for the Reporter, were written in his chamber. 
We will view him at this j)oint for a moment, where we now are — in his 
chamber. We saw him, wasted by disease, and yet firm in mental pow- 
er. He spoke to us of his sufferings, as a victor speaks of conquered 
enemies : they may have been strong, but the mind had soared above 
them. His words were few, but they spo7ce. Some words sound only ; 
Ms j uttered meaning. As he entered the stream that separates the noise 
of time, from the stillness of eternity, and felt ; its waters to chill his 
blood, and its cold waves to approach the centre of life, the spirit still 
seemed to hold its gaze upon an unending existence, and with a- firm 
and steady, yet quiet advance, he passed away, and left these words 
of the Psalmist to answer the question— How did he die ? " Thy rod 
and Thy staff, they comfort me." Thy rod for discipline, Thy staff for 
support; they both comfort me. 

A word about his acquirements. In the profession of his choice Dr* 
P. was thoroughly versed. Its history was familiar to him ; and in dis- 
cussing the doctrines of those who have given to our profession its caste^ 
in times ancient, and modern, in all countries, he seemed quite at ease 
both in social intercourse, and in the lecture room. His knowledge of the 
Latin and Gresk languages enabled him to cull from the past, much that 
was embellished by his own rich style, in the Various literary and sci- 
entific productions which have emanated from his study. The Hebrew 
he knew so familiarly as to be able to read with a critical eye, its trans- 
lations, .and to dwell upon the imagery of this virgin tongue with de- 
light and profit. In the modern languages, he was quite a proficient. 
35 



270 Editorial. [June, 

The French, German, and Italian, he read and spoke with ca?e, and had 
so acquainted himself with the classical poetry of the latter, as to be 
always ready to render quotations off-hand, but without ostentatious ef- 
fort at display. In Egyptian philology he found much to interest his 
taste for studying oriental symbolisms, and had his life been prolonged, 
he would probably have published his notes on the subject. In the 
practice of his profession he was gentle, kind, and skilful. 

His disease. "When a prominent member of our profession passes from 
earth, it is expected that his disease should be known to his professional 
friends, and that the post-mortem revelations made by the scalpel, should 
be the common property of the profession. With a few exceptions, we 
believe this is usually the case, and we admire the devotion to science, ma- 
nifested by domestic and personal associates who cheerfully allow the pro- 
fession to use these means for advancing the common interests of our 
race. In presenting the following statement, we do not write from any 
examination into tbe disease of Dr. Patterson, made by ourself, but from 
information obtained from his physician, friend and colleague, Prof. 
Darrach, of this city. In April of last year, (1853,) Dr. Darrach made a 
critical examination of his case, and gave to his family, and friends the 
following diagnosis, which was repeated before the College Class, in an 
introductory lecture, delivered in October last, as a reason for Dr. P's 
resignation from the Faculty. He declares his retirement to be owing 
to " pleuritic and cordal sequelae of rheumatismal influenza, which, how- 
ever much it embarasses the mechanism of the arterial circulation, and 
emaciates, and weakens, has not lessened the pulmonary function, nor in 
the least abated his emotions , passions, and intellect." Dr. P., was ex- 
posed during a stormy night in 1844, and " contracted an influenza 
which established a liability to attacks of neuralgic rheumatism." There 
followed upon this an " insidious, painless, chronic pleurisy, which plas- 
tered down the right lung ; and subsequently, a similar persistent trans- 
mutation was made upon the valves of the heart, to embarrass their ac- 
tion." These sequalae, according to Dr. D, " occasioned an atrophy of 
the right, and a vicarious enlargement of the left lung, which displaced 
the heart to the middle sternal region of the right side of the chest. ? 

The autopsy. Thirty hours after death, the emaciated frame was ex- 
posed for dissection, and the following appearances are reported. (The 
cranium was not examined ) " Thorax — heart, moderately enlarged, 
displaced towards the right side, extending one and a half inches beyond 
the articulation of the right ribs, with the cartilages, — pericardium 
healthy, about two ounces of fluid in the cavity, — right cavities; auricle^ 



1854.] Editorial 271 

filled with a very dark colored heart clot; endocardium, normal; 
walls thinner than normal — ventricle, walls thinner than normal — tri- 
cuspid valves not affected — clot clinging to cordae tendinse — semilunar 
valves of pulmonary artery red, thicker than normal, and fleshy to feel — 
long clot in the pulmonary artery — left cavities ; auricle empty — endo- 
cardium normal, except mitral valves, which were thickened with de- 
posits; the deposits being in lumps or beads, along the edges, and caus- 
ing the valves to curl upon themselves. Ventricles, nothing peculiar. 
Valves of aorta, red, thickened, and fleshy to feel ; the redness of these 
valves, together with those of the pulmonary artery, could not be wash- 
ed off by water, and they presented a stroug contrast with tne color of 
the rest of the lining membrane of their respective arteries. This con- 
dition was more morbid in the valves of the aorta than in those of the 
pulmonary artery. 

Lungs — right, firmly bound down by adhesions ; being almost one 
fourth the natural size. The lateral diameter greatly diminished : the 
vertical slightly. At the apex, the air vesciles were very much dilated, 
and few in number; the great portion of lining tissue being absorbed. No 
evidence or sign of tubercle. Lung did not crepitate, the lower portion 
being tough and carnified. It contained air sufficiently to float it in 
water. At the postero-inferior portion, was a patch of cardaceous mem- 
brane of about the sixth of an inch in thickness. Left lung adherent, 
but by no means as firmly as was the right ; hypertrophied and crepi- 
tant throughout— much congested and oedematous. No evidence of tu- 
bercle in any part of the organ. The adhesions of both lungs were so 
firm, that much of the costal pleura was torn out in the attempt to libe- 
rate them. Bronchial tubes. Fine injection — fibrous appearance inter- 
nally, with hypertrophy of follicles. 

^prif 28^,1854." 

We have attempted thus to bestow upon the memory of one with 
whom we were associated as a co-worker, a humble tribute of es'eem, 
by presenting a faint picture of his mind in its vigor, and nobility, during 
life; in its calmness in the hour of dissolution, and of the frail mor- 
tality as it yielded to the grasp of an unconquerable malady, with a pa- 
thological description drawn by his friend and physician. 

We would have been glad to have accompanied this notice by a por- 
trait of the deceased, but previous engagements will not permit our doing 
so now. P. 



272 Editorial. [June, 

ABOUT OURSELVES. 

|@T" Those who peruse the present number of the Reporter, will 
perceive that it is a valuable one. The number and variety of the ori- 
ginal communications, — -the reports of Transactions of local medical so- 
cieties, all having a general, as well as a local interest,— the Bo6k 
notices, and Editorial, — the special and full report of the Transactions 
of the American Medical Association- — and finally, the admirable and 
correct likeness of our distinguished countryman, A. H. Stevens, M. D. ? 
of New York, (engraved expressly for the Reporter,) combine to make 
this a rare number. 

We will say to our readers, that the expense of getting up such a num- 
ber is very great, and notwithstanding the fact that our subscription list 
is encouragingly large, and still increasing, we need all the influence 
they can each bring to bear to increase the number of subscribers, and 
thus give us the means not only to carry out the plans we have already 
laid out, but to enable us to institute new ones, ivhich we will do as fast 
as our means will warrant, to make our Journal useful and attractive. 
There is no other medical journal we believe, in the world that furnishes 
its readers with steel engraved likenesses, with biographical sketches of 
distinguished medical men. 

We have already published four steel likenesses, besides one engraved 
on wood, and the July number will contain the portrait and a biographical 
notice of the venerable John C. Warren, M. D., Of Boston, while several 
others are expected to appear before the close of the current volume. 

Will not our readers who are not subscribers, encourage us by sending 
in their names, and will not our old friends labor a little for us? 

To those who are in arrears, we would say that while we send out 
such numbers as this, we' shall not be backward about sending them re- 
minders of their indebtedness. They will find us an inveterate dunn — 
but do w^ not use the money well when we get it ? 

$^§*We have considerable matter on hand for the next number, among 
which are papers on Cynanclie Trachealis, by William Johnson, M. D., 
and on Placenta Prwvia, by 0. H. Taylor. M. D. 

Will not our correspondent in Montezuma, N. Y., communicate with 
US in regard to procuring fresh vaccine virus from the cow? 



1854.] .. American Medical Association. 



AMERICAN MEDICAL ASSOCIATION. 

PROCEEDINGS OF THE SEVENTH ANNUAL MEETING, HELD IN ST. LOUIS, 

MISSOURI, MAY 2d, 1854. 

Specially Reported for the New Jersey Medical Reporter. 

In the morning at 11 o'clock the Association convened in Verandah Hall. 

In the absence of the President, Dr. Jonathan Knight, of Connecticut, Dr. Usher 
Parsons of Rhode Island — the senior Vice-President — called the Convention to order, 
and announced that the Vice-Presidents and Ex-Presidents were entitled by courtesy 
to seats on the platform. 

Dr. Edwin S. Lemoine, of St. Louis, took his seat as Secretary. The following let- 
ters from Dr. Knight, President, and Dr. Beadle, Senior Secretary, and also a commu- 
nication from Dr. John G. Adams of Paris, were then read by the Secretary. 

New Haven, Conn., April 25, 1854. 
To Edwin S. Lemoine, M. D., Secretary of the American Medical Association, St. 
Louis, Missouri. 

Dear Sir: As the time is near at hand for the assembling of the American Medical 
Association, it is proper for me to inform you, and through you, the members of the 
Association, that it will not be in my power to be present at the annual meeting. I 
have come to this conclusion after much reflection, wilh great reluctance. The meet- 
ings of the Association have always been periods of high gratification to me. 

The acquaintance there formed, and the intercourse had with the members of the 
profession from every part of the country, have been among the most gratifying events 
.of my life. I have looked forward to the annual meeting of this year, with the antici- 
pation of unusual satisfaction. There was a portion of the country new to me, to be 
visited: there were members of the profession, probably in large numbers, few of 
whom were known to me, to become acquainted with, in addition to the ordinary at- 
tractions of the meeting, which made me strongly desirous for my own sake to be pre- 
sent. 

At the same time, I feel the full weight of the obligation to attend the meeting this 
year, arising from the high honor which has been conferred upon me by the Associa- 
tion. Perhaps no one so little deserving, has received so many and so^great favors 
from the medical profession, and I take this opportunity to renew my acknowledg- 
ments for these favors. 

Tt is with no ordinary emotion that, although absent, I greet those of my profession- 
al brethren who will be present at St. Louis. I do this with the most cordial feelings, 
and with the strongest wishes for their welfare. Allow me, also, to express the con- 
fident hope that their wise deliberations will result in the promotion of the best inte- 
rests of the profession, and advantage of the country, and to ask that the blessing of 
God may rest upon their labors. 

With esteem and respect, your ob't servant, J. KNIGHT. 



New Haven, April 15tji 5 1854. 
To Usher Paesons. M. D., Providence. 

My Dear Sir : As the time is near at hand for the meeting of the American Medi- 
cal Association at St. Louis, it is proper for me to inform you that I shall not probably 
be able to attend it. Matters of a purely personal nature will, I suppose, deprive me 
of that pleasure. As you are the Senior Vice-President of the Association, I trust 
you will be present and perform the duties which will devolve upon you. 1 give you 
this early notice that you may have time to prepare such an address as may be pro- 
per for the occasion. That you will do this as you do everything else, (in the best 
manner,) I have no doubt. 

With esteem and respect, your obedient servant. J. KNIGHT. 



274 American Medical Association. [June, 

New York, April 22d, 1854. 
To Jonathan Knight, M. D., President of the American Medical Association: 

Sir: I find myself obliged to announce to you that business, not professional,, per- 
emptorily demands my presence in this city till a period subsequent to that fixed for 
the convening of the Association. This I most sincerely regret, not only because it 
will deprive me of much anticipated pleasure, but prevent me from discharging all 
the duties appertaining to the office I hold. Permit me, through you, to convey to the 
Association the assurance that I am deeply sensible of the honor conferred upon me 
by twice electing me one of its Secretaries, and that I shall ever rejoice in the increas- 
ing prosperity and extending aid and commanding influence to this great National 
organization. I have the honor to be, most respectfully, 

Your obedient servant, E L. BEADLE. 



Marseilles, March 19th, 1854. 
Dr. E. L. Beadle, Secretary of American Medical Association : 

Please to state to the American Medical Association, at their meeting in St. Louis, 
that I have presented to the Imperial Academy of Medicine at Paris, the Sixth Vol- 
ume of their Transactions; that it was received by their most distinguished body with 
much favor, and that it was referred to a committee for examination and Report (M. 
Velpeau, Chairman). 

1 have also promised M. Dubois, Perpetual Secretary of the Academy, to endeavor 
to procure for the Academy the five previous volumes, and I feel assured the Aca- 
demy would take much pleasure in establishing a correspondence with our American 
Medical Association. With great respect, yours truly, 

JOHN G. ADAMS, Permanent Member. 

The President said that the Association having assembled, were ready to hear from 
the Committee of Arrangements. Dr. James R. Washington, of St. Louis, Chairman 
of said Committee, now addressed the Convention in substance as follows: — 

Mr. President, it is my pleasing duty, in the name of the profession of St. Louis, to 
welcome our medical brethren of the Union to our young city. To say, gentlemen, 
that we are delighted to see you, would express very imperfectly the emotions we ex- 
perience on this occasion. The recurrence of this anniversary is looked forward toby 
its friends throughout the country with anxiety and hope, and with none of the fears 
which the original advocates of this Association entertained for its successful opera- 
tion. Their most sanguine hopes have been fully realized in the good already accom- 
plished — but while so much remains to be done, it is natural that these meetings should 
be anticipated with great interest. We, of St. Louis, share this general feeling; but we 
have been expecting this, the seventh anniversary, with great solicitude. This city 
having been selected as the place for the meeting of the Association, we were desir- 
ous that in every respect it should pass off well, and be remarkable for the good done 
and the interest excited. We have felt all the nervous excitement which is experi- 
enced by a young lady making her debut in society. We knew we were asking a 
great deal when we invited the Association to appoint this meeting here — the older 
cities of the East having so much to make a visit to them desirable, while we have 
but little of interest to present. Had we been vain of display, then would it have been 
premature; but being desirous of manifestingour interest in medical advancement 
and reform, we were induced to offer St. Louis to the notice of the Association. We 
feel complimented that the invitation was accepted. We are truly happy at seeing 
you here, and right cordially do we welcome you — at the same time congratulating 
ourselves on the event of your being with us. On behalf of the Medical Society of 
St. Louis he cordially welcomed the gentlemen of the Association to the city, stating 
that the occasion was looked forward to with a great deal of interest. The fears which 
had previously existed in regard to the efficacy of the Association had now passed 
away, in the evidence of the good accomplished. We of St. Louis greet this seventh 
anniversary of the Medical Society with peculiar interest, aad have hoped that it 
might be remarkable for the interest excited, and in the evidence of good done. We 
knew that it was asking a great deal of the Association to meet here, and consider our. 
selves complimented by the occasion. Our city has never served an apprenticeship as 
a town, but grew immediately out of a village and trading post. We, therefore, feel 
complimented by your presence, and have cause to congratulate ourselves that our 
invitation was accepted. 



1854.] 



American Medical Association. 



275 



Dr. Parsons then arose, and spoke in substance as follows. 

Gentlemen of the Committee of Arrangements, 1 thank you in the name of the As- 
sociation, for the kind welcome which you have been pleased to extend us. We have 
looked forward with great interest to this occasion, and to the opportunity we now 
have of taking- our brethren of St. Louis by the hand, and in greeting you. Our road 
has been long, but we have been repaid by beautiful views, and a sight of your flour- 
ishing city. We are happy to take you by the hand, and greet you fur the purpose or 
co-operating with you in the advancement of the objects of our Association. 

The chair then announced that the business first in order, was to call the roll of 
Delegates. 

Dr. March of Albany, New York, suggested that each gentleman as his name was 
called, should rise to his feet, at the same time answering to his name — which was 
approved. 

The following list comprises the names of all the delegates and members reported 
at various stages of the proceedings. 



Maine Medical Association, 



MAINE. 

J Joseph H. Eastbrook, 
{ Charles Millet. 

Lewiston Falls Med. Association, Sylvester Oakes. 

Portland Medico- Chir. Society, Sumner B. Chase. 

NEW HAMPSHIRE. 
State Medical Society, John 0. French. 

MASSACHUSETTS. 

C John Green, 
A. A. Gould, 
John Flint, 
Ephraim Lovell, 

<J Benjamin F. Hey wood, 
Alfred Hitchcock, 
James W. Stone, 
Charles D. Homans, 
Francis Minot. 
J. N. Bates. 
J. B. S. ^Jackson. 
D. H. Storer. 



Massachusetts Medical Society t 



Worcester Co. Medical Society, 
Boston Soc, for Med. Improvement, 
Massachusetts Gen. Hospital, 

RHODE 

Rhode Island Medical Society, 



Connecticut Medical Society, 
Med. Institution of Yale College, 

NEW 

Albany Medical College, 
Geneva u " . 

New York Co. Medical Society, 



ISLAND. 

Usher Parsons. 
CONNECTICUT. 

f P. G. Rockwell, 

( Nathan B. Ives. 

Charles Hooker. 

YORK. 

Alden March. 

Joel E. Hawley. 
( James D. Phelps, 
( Henry S. Downs 



276 



American Medical Association. 



[JuN£, 



*r v i c/ / xrj- 1 c< --4 f Thomas W. Blatchford, 
JSIeto liorfc folate Medical Society, < v> p> All 

Med. Assoc, of Southern Cent'l NY \ t ' , „ tt I 

J { Joel E. Hawley. 

New York Academy of Medicine, 

College of Phys. and Surgeons, 

New York Medical College, 

University of Buffalo, 

Wayne Co. Medical. Society, 

Herkimer Co, Medical Society, 

NEW 



Lewis A, Sayre. 
Chandler R; Gilman. 
E. H. Davis. 
James P. White. 
A. Mclntyre. 
Caleb Budlong. 



State Medical Society, 

Essex District Medical Society, 
Camden , " u " 



State Medical Society, 

Philadelphia Co. Medical Society, 

University of Pennsylvania, 

Pennsylvania Hospital, 

Medico- Ch ir . College, 

Philada. Assoc. Med. Instruction, 
College of Physicians, 
Northern Med, Assoc, Philada., 
Chester Co. Medical Society, 
Montgomery Co. Medical Society, 



Lancaster City and County Medi- 
cal Society) 



JERSEY, 
f L. A. Smith, 

| F. S. Schenck, 
G. R. Chetwood. 
Richard M. Cooper. 

PENNSYLVANIA. 

f John L. Atlee^ 
\ John D. Ross. 

Rene La Roche, 
f Joseph Leidy, 
| Joseph Carson. 

George W. Norris. 
( Samuel H. Meade. 
I J. B. Bell. 

Francis West. 

John B. Biddle, 

N. L. Hatfield. 

Isaac Thomas. 

William Corson. 
C Samuel Keneagy, 
I John Ream, 
J Samuel Parker, 

Isaac C. Weidler, 

P. Cassiday, 

0. S. Mahon. 

William Keith. 



Permanent Member, 

VIRGINIA. 
Medical Society of Virginia, Adam Spitler. 

SOUTH CAROLINA. 

fj. L. Dawson, 
WW TT F ft 

State Medical Association, 



Medical College, South Carolina, 



Ford PrioleaUj 
Robert S. Bailey, 
William C. Ravenel. 
f Henry R. Frost, 
( Thomas G. Prioleati; 



.] 



American Medical Association. 



27Y 



ALABAMA. 

State Medical Association, S. W. Clanton, 

MISSISSIPPI. 

Jefferson Co. Med. Association, T. J. Grafton. 

LOUISIANA. 

State Medical Society, E. D, Fenner, 

KENTUCKY. 

Med. Dep. Transylvania Uhiver,, John R. Allen. 
University of Louisville, 
Kentucky Medical School, 

Marine Hospital at Louisville, 

Permanent Member, 

OHIO. 

W, W. Taggart, 
Robinson. 



Samuel D. Gross. 

R. J, Breckenridge. 
f J. W. Scott, 
( John Magoffin, 

Walter A. Norwood, 



Wayne County Medical Society, 



(W, T\ 
(J. D. 



Cincinnati Medical Society, 

Medico- CJiirurgical Soc, of Cin. 

State Medical Association, 
Miami Medical College, 
Hampden Co. Medical Society, 
Montgomery Co. Medical Society, 
Belmont Co. Medical Society, 

Members by invitation, 



W. T. Taliaferro, 
L. D. Waterman, 
M, B. Wright, 

: H. B. Musgrave. 

f Robert R. Mcllvain, 
0, M. Langdon, 
J. J. Arons, 
William Clendenin, 

|^C. B. Hughes, 
Amos C. Smith. 

I George Mendenhall, 

I R. D. IViussey, 

J. E. Nagle. 

C I. A. Coons, 

£ Joshua Clements. 

J. T. Updegraff. 

f John W.Bond, 
< L. D. Waterman, 
(^ Charles Grant. 

INDIANA- 

Evansville Medical College f j T) M ' 

Vincennes Medical Society, W. W. Hitt. 

Permanent Member, J. L. Mothershead, 

Member by invitation, Edward Murphy, 
.36 



278 



American Medical Association. 



[June, 



MISSOURI 



State Med. Association, 



i 



St, Louis Medical Society, 

Med. Dep of St. Louis University, 
St Louis Hospital, 
Med. Dep. of University of Mo., 
St. Louis German Med. Society, 
St. Louis City Hospital, 

St. Louis Med. Institute, 

0' Fallen Dispensary, 
U.- S. Marine Hospital, St. Louis, 
Dispensary of University of Mo., 
Pike County Med. Society, 
Randolph Go. Med. Society, 

Franklin Co. Med, Society, 






' Charles Quarles Chandler, 

George Engleman, 

Thomas Reyburn, 

David C. Tandy, 

John Barnes, 

S. Pollak, 

L. P. Perry, 

H. A. Prout, 

David M. Cooper, 

Stephen W. Adreon,- 

Alexander Marshall, 

J. W. Wilson, 

H. Schoenich, 

William P. Boulware, 

Isaac P. Vaughan, 

Hammond Shoemaker^ 

John Laughton, 

W. A. Jenkins. 

S. Gratz Moses, 

George S. Walker, 

A. J. Coons, 

Jas. R. Washington, 

Edwin S> Lemoine, 

F. E. Baumgartner, 

William S. Edgar, 
IW, S.Golding. r 

J William M. McPheeters,- 

{ R. S. Holmes. 

f M. L. Linton, 

( Charles A. Pope. 

\ John S. Moore, 

{ Joseph N. McDowell. 

| Alfred Behr, 

{ Adolphus Wislizenus, 

f E. Y. Bannister, 

( J. B. Johnson. 

| J. S. B. Alleyne, 

\ John O'Fallen Farrar, 

Charles W. Stevens. 

George Johnson. 

Abner Hopton. 

John C. Welborn. 

R. K. Lewis. > 
f J. W. B. Reynolds, 
{ Pierce N. Butler. 



1854.] 



American Medical Association. 



279 



La Fayette Co, Med. Society, 

Chariton Co. Med. Society, 
Cooper Co. Med. Society, 
State Deaf and Dumb Asylum, 

St. Louis Co. Hospital, 

State Prison Hospital, 

St. Louis Co. Lying in Hospital, 

St. Louis Co. Insane Hospital, 

Biddle Lying in Hospital, 

St. Louis Quarantine Hospital, 



Permanent Members. 



( J. F. AtkinsoD, 
\ John B. Alexander. 

M. J. Rucker. 

George C. Hart. 

A. A. Ryley. 
J Richard F. Barritt, 
( G-eorge Penn. 

W. A. Curry. 

J. M. M'Keage, 

Joseph Buron. 
f Charles L. Boisliniere, 
I M. M. Pallen. 

F. P. Leavenworth, 
f A. Litton, 

1 Charles W. Hempstead, 
(William Webb. 



State Med. Society, 

South Western Med. Association, 
Detroit Med. Association, 



MICHIGAN. 

( A. B. Palmer, 
{ J. H. Beach. 

Andrew Murray. 

William Brodie. 



IOWA. 



State Med. Association, 

Med. Dep. Iowa University, 

North Western Med. Society, 
City Hospital, Keokuk, 
Clinton Med. Society, 
Keokuk Med. Society, 
Permanent Member, 



f JohnD. Elbert, 
< Thomas Seviter, 
(John H. Rauch. 

C D. L. M'Gugin, 
{ E. R. Ford. 

John F. Ely. 

E. A. Arnold. 

N. Van Patten. 

J. C. Hughes. 

J. F. Sanford., 



ILLINOIS. 



State Med. Society, 

State Med. Society, 
Morgan Co. Med. Society, 
Cook Co. Med. Society % 



E. S. Cooper, , 
Samuel Thompson, 
Rudolphus Reuse, 
H. A. Johnson, 
William W. Welch, 
Samuel Long. 

(W. Henry Davis, 
S. A. Paddock. 
David Prince. 

fW. C. Quigley, 
( James Bloodgood, 



£80 



American MedicaI Association. 



[June, 



Itnox Co. Med. Satiety, 
Pekin Med. Society i 
Rush Med. College) 
Adams Co. Med. Society) 
McLean Co-. Med. Society) 

Macon Co. Med. Society) 

jEsculapian Med. Society) 
Alexander Co. Med. Society) 
Peorid Med. Society, 
Hospital Sisters Mercy Chicago, 
La Salle Co. Med. Society) 
Madison Co, Med. Society, 
Winnebago Co. Med. Society) 
Stark Co. Medical Society) 

St. Clair Co. Med. Society) 
Permanent Members) 



Members by Invitation, 



! James Butiee, 
J. W. Spalding. 
( J. S. MaUs, 
(J. C. Hinsey. 

J Daniel Brainerd, 
W. B. Herrick. 

{Daniel Stahl, 
J. N. Ralston. 

( G-eorge W. Stipp, 
\ T. P. Rogers. 
J S. Y. Baldwin, 
( S. Y. Trowbridge. 

Thomas D. Washburn* 

"William "Wood. 

E. L. Colburn. 

N. S. Davis. 

Joseph Stout. 

George S. Allen. 

Charles W. Clark, 

Hiram Nance. 
J John B. Gray, 
I James A* Roman. 
I M. Shepherd, 
( Adam Nichols. 

W. P. Golliday, 

L. G. Thompson, 

W. C. Harrington, 

S. W. Kincaid, 

Joseph King, 

D. Skilling, 

H. W, Kendall, 

"William Robinsoil, 



WISCONSIN. 



State Med. Society) 
Western Med. Association) 



5 John "B. Dousman, 
John K. Bartlett. 
George D. Wilber. 



TENNESSEE. 



State Med. Society, 



Montgomery Co. Med. Society, 
Memphis Med, Collect* 



C Frank A. Ramsay, 
•2 H. M. Clements, 
(^ J. B. Lindsley. 
< C. R. Dabney, 
J J. L. C. Johnston. 
C Louis Shanks, 
I A. P. Merrill. 



1854.] 



American Medical Association. 



ttl 



Med. Dep. University of Nashville, 

Nashville" Med. Society, 
State Lunatic Asylum, 
Sumner Co> Med. Society, 
Permanent Member, 

MINN 
Minnesota Med. Society, 

United States Army, 

United States Navy, 

Med. Soc. of Cherokee Nation . 



William K. Bowling, 
„ Paul F. Eve. 
J. B; Lindsley. 
George R. Grant. 
William D. Haggard. 
C. B. Guthrie. 

£ S T A. 

John H. Murphy. 
( Clement A. Finley, 
I A. N. McLaren. 

Ninian Pinkney. 

R. D. Ross. 



The roll being called, Dr. Parsons, the vice-President announced that the Associa* 
tion was duly organized, and stated the business first in order. 

The Secretary now read the report of the committee on Publications — the chauS 
man, Dr. Gondie, being absent. 

The report, on motion of Dr. Atlee, of Pennsylvania, was laid on the table for future 
action. 

Also, the report of Dr. Condie, as Treasurer of the Association, was read and order- 
ed to lie on the table until audited. 

On motion of Dr, White, of New York, a recess of fifteen minutes was taken, to 
allow the delegates of each state to meet and select one of their number to act as a 
nominating committee to report officers for the ensuing year. 

The Association again came to order, and the following persons were announced 
as the committee on nominations : 



Maine, 

Massachusetts, 

Connecticut, 

New York, 

New Jersey, 

Pennsylvania, 

Virginia, 

Minnesota, 

S. Carolina, 

Illinois, 

Indiana, 



Dr. Charles Millet, 
" D. H. Storer, 
" P. G. Rockwell, 
" L. P. White, 
u George R.Chetwood 
: ' Rene La Roche, 
" Adam Spitler, 
" J. H. Murphy, 
" Thomas G. Prioleau, 
" W. B. Herrick, 



Alabama, 

Louisiana, 

Missouri, 

Michigan, 

Mississippi, 

Iowa, 

Tennessee, 

Wisconsin, 

Kentucky, 

Ohio, 

U. S. A. and N. 



« S. W. Clanton, 

" E. D. Fenner, 

» Thos.G.Reyburn, 

" William Brodie, 

" T. J. Grafton, 

" D. Seviter 

" J. B. Lindsley, 

" J. B. Dousman, 

" R. J. Breckenridge, 

" O. M. Langdon, 

" Ninian Pinckney. . 



" W. W. Hitt, ( 

The committee on nominations retired for the purpose of selecting candidates for 
President, vice-President, Secretary, and Treasurer. On motion of Dr. Atlee, Of Pa. 
the hours of sessions of the Association were fixed at from 9 A. M. till 1 o'clock P.M., 
and from 3 till 6 o'clock P. M. 

Dr. Hooker, of Connecticut, moved that the nominating committee be instructed td 
recommend the place for the next annual meeting of the Association. Approved. 

Invitations were now received from the cities of Detroit and Philadelphia, warmly 
urging the Association to hold its next meeting in those places. 

Dr. Brainerd, of Illinois, offered the following resolution. 

Resolved, That hereafter the American Medical Association will hold its meetings 
alternately in the southern, northern, and western divisions of the United States. The, 
resolution gave rise to considerable discussion, and was finally, on motion of Dr., 
Barries, of St. Louis, laid on the table. 

On motion, the meeting adjourned to meet at 3 o'clock, P. M.- 



282 American Medical Association. [June> 

AFTERNOON SESSION — Tuesday, May 2. 

The Association met at 3 o'clock P. M. pursuant to adjournment— one of tbe Vice- 
Presidents, Dr , Henry R. Frost, of S. C, in the chair. The presiding officer then announ- 
ced that the next business in order would be the reading of the usual annual address 
of the President, and that Dr. Parsons, of Rhode Island, the senior vice-President 
would, in the absence of the President, perform that duty. 

Dr. Parsons then read the following address. 

Gentlemen of the American Medical Association ; it has been customary for the Pre- 
siding Officer of this Association, on retiring from the chair, to give a valedictory dis* 
course. On the eve of my departure from Rhode Island, our venerable President notified 
me of his inability to aitend and perform this part of his official duty, which deprives us 
of the rich entertainment anticipated from so distinguished a scholar and professor. 
The notice being entirely unexpected, lam unprepared to offer you anything worthy 
of your attention, and my inclination would therefore be to remain silent, but for an 
apprehension that this course might operate as a precedent to others on similar occa- 
sions, I will therefore present you rather as an apology for a discourse, a few thoughts 
that have suggested themselves while on my way to this city. 

In order to promote the honor, dignity and usefulness of our profession, objects for 
which the Association was instituted, its memhers must be gathered from all parts oi 
our country, and united into one harmonious fraternity, and must adopt such mea- 
sures as will promote and perpetuate among ourselves an esprit de corps, a conformi- 
ty of sentiment and feeling, and a combination and co operation in action. This has 
already been accomplished in a good degree by holding our annual meetings in dis- 
tant and remote cities of the Union. They must continue to be carried to new and 
ever varying spheres of action, until their beneficial influence is made available to the 
whole profession. As the metallurgist in separating a heterogeneous mass* of 
particles passes over it a magnetic bar to attract the pure iron and steel with a force 
proportioned to its proximity, so must the meetings of this Association, in order to 
gather into one fold suitable materials of growth and strength, be carried from place 
to place over the whole mass of our population, attracting from the dross and 
impurities all that is of value and worthy of reception and incorporation into a homo- 
geneous and efficient brotherhood. These considerations influenced me in voting to. 
accept the invitation to hold the present meeting in Missouri, notwithstanding the toil 
and fatigue of the journey, and its remoteness from the residence of u large propor- 
tion of the delegates. It is here more than elsewhere, that the meetings of this Asso- 
ciation are likely to prove beneficial by a rapid enlargement of our numbers. 

Whoever glances at a map of the Mississippi Valley, extending from the base of the 
Alleghany and Cumberland Mountains to the margin of the Ptocky Mountains ; from 
the Highlands bordering on Lake Superior, to the Gulf of Mexico, and contemplates 
the fertility of its soil, its adaptation for cereal productions, which are so necessary for 
human subsistence and increase, and who surveys the majestic Mississippi, naviga- 
ble through this whole territory, with its numerous navigable tributaries pouring in 
their treasures on either side, and adds to this the vast mineral resources, lead, iron, 
copper and coal, which are far more conducive to healthful opulence than the golden 
regions of California— ^whoever, I say, candidly, surveys all these elements of future 
growth, expansion and power, and moved onward by the agency of steam on land 
and water, and labor saving mechanical manufacturing operations, can arrive at no 
other conclusion than that this vast territory, the largest and most favored one by na- 
ture of any under the whole canopy of Heaven, will, in time, be densely populated 
with scores of millions, and become the seat of empire of the western world ; and that 
it is destined to be the grand theatre of human progress in every department that is 
calculated to advance the dignity and promote the happiness of the human family. 

And in no department of human affairs is progress here more sure than in medical 
knowledge. Our Atlantic States have inherited a reverence for European opinions, 
which, although commendable in our early medical history, is at the present day less 
favorable to American progress, and discovery in medicine. "We need to interrogate 
nature and experience more, and European opinions less. "We need mental as well 
as political independence — the freer swing of thought and purpose that characterizes 
our brethren of the West, and which this Association is adapted to call into action. 

There is much to encourage you in your recent discoveries and contributions, in 
the results of the vivisections of Saurians, the half of which, if confirmed by future ex- 



1854.] 



American Medical Association. 283 



periments, will shed new light on Pbisiology : and again, in the discoveries made re- 
lating to the process of digestion, by your late lamented Beaumont, of St. Loui9, who 
for the theories and speculations before prevailing, has substituted occular demon- 
stration of the modus operandi of that wonderful process, by submitting to it the vari- 
ous articles of human aliment, and determining the length of time required for con- 
verting each into healthful chyme ; and again, in the successful labors of Drake in 
traveling from State to State throughout the valley, collecting the history and charac- 
ter of its epidemics by personal inquiry and observation. Others of your venerated 
dead might be mentioned who have pursued a like independent course untrameled 
by prevailing European authorities. Of their immediate successors who now stand 
at the head of their profession, it would ill-become me to speak, seeing that some of 
them are present and unused to such freedom of remark. But to the junior members 
of the profession we would say, " unite with us — follow the example of the distinguish- 
ed pioneers I have named, and of Caldwell and Harrison who have gone to their re- 
ward; throw the result of your labors into the common stock of medical knowledge, 
accumulated by this Association, where, rest assured that they will be duly apprecia- 
ted to the common benefit of the profession and of mankind, and redound eventually 
to your everlasting honor and professional fame." 

Gentlemen, eight years have elapsed since the preliminary meeting of the Convec- 
tion which recommended the formation of this National Association, and the results 
of its labors have equalled the expectations of the friends of reform and progress in 
our profession. The six published volumns of Transactions have successively in= 
creased in value and interest, and are enduring monuments of the ardent zeal and 
patient industry of the numerous contributors, and there is every reason to hope that 
our future labors will continue to be crowned with equally increasing success. 

Gentlemen, A^e are reminded by the history of the past year, of the frailty of human 
life. Death has removed many of the brethren of this Association. Among others its 
first President, Professor Chapman, of Philadelphia, a veteran teacher in our oldest 
Medical College — Professor Caldwell, another veteran of great distinction, as a lec- 
turer and an author — Professor Howard, of Ohio, an eminent surgeon, editor of the 
Ohio Medical Journal, and who was Vice-President of this Association at the time of 
his decease — Dr. George C. Shattuck, LL. D., Boston, an extensive practitioner, and for- 
merly President of the Massachusetts Medical Societv. He was reputed the wealthi- 
est physician in New England, and his numerous bequests to educational, humane, 
and religious institutions, and private enterprises and charities, proclaim that his phi- 
lanthropy was proportioned to his opulence. 

We are reminded by the return of this anniversary, of the terrible catastrophe that 
occurred at Norwalk. The Association had received from our brethren of New York 
a cordial welcome, and were honored with overflowing hospitality. After a delight- 
ful and profitable session, the Association adjourned, and many of the members were 
on their way in cars to their respective homes, in joyous anticipation of rejoining 
their families, when in a moment, in the twinkling of an eye, seven of them were 
launched into eternity, leaving us the solemn admonition, that "in the midst of life we 
are in death." I should deem it a duty on this occasion, to pay a tribute of respect due 
to their memory, by portraying their many virtues and excellencies as men and as 
physicians, had I not ascertained that justice will be done them by an abler pen. Our 
brethren of New York, with characteristic magnanimity, which adds to their claim on 
our gratitude, immediately on the announcement of the disaster, summoned a meet- 
ing and passed resolutions expressive of their deep sorrow at the sad event; and they 
also appointed a committee to prepare an eulogy on the deceased, to be offered at 
this annual meeting, and the distinguished ability of the chairman and members of 
that committee is a sufficient guarantee that justice will be done to the memory of 
these, our lamented brethren. 

On motion of Dr. Atlee, of Pa., the thanks of the Association were tendered Dr. Par* 
sons for his Address, which was then referred to the Committee on Publications, and 
-ordered to be printed with the transactions. 

The following report of the New York Committee was read by the Secretary and 
their recommendations adopted. 

TO THE AMERICAN MEDICAL ASSOCIATION. 
At a special meeting held in the city of New York, on the 12th of May, 1853, of 
such members " of the American Medical Association as reside in this citv and its 



284 American Medical Association. [June, 

vicinity, and such as were remaining here from abroad, for the purpose of expressing 
tneir feelings respecting the disaster on the New York and New Haven Railroad at 
Norwalk,in Connecticut, which resulted in the death of so many valuable members 
■of the Association," after adopting sundry resolutions expressive of their sentiments 
and sympathy with the bereaved, a, committee of seven was appointed to devise 
some suitable method of commemorating the event and the worth and professional 
character of our lamented associates, and to recommend said plan to the next annual 
meeting of the Association. 

At a meeting of the Committee thus appointed, it was resolved, that in the opinion 
of the Committee, theanost appropriate method of carrying into effect the objects had 
in view in their appointment, would be by preparing a narrative of the event, togeth- 
er with a brief biographical sketch of each individual, which shall embrace a notiee 
of the birthplace, age > place of education, when and where they derived their medical 
authority, where located after entering the profession, tastes and habits of life, if any, 
to what particular branch of the profession devoted, what positions held in the profes- 
sion, either as professors, presidents or officers of Medical Societies, what literary 
labors, medical or otherwise, performed, what done to advance the science of medicine ; 
and that such narrative and biographical memoirs be published in the next volume of 
the Transactions of the Association. 

The Chairman and Secretary of the Committee beg leave to state that, although 
they have taken measures to procure the materials for preparing the Biographical 
Memoirs, answers to all the letters of inquiry have not been received. In reporting 
the above proceedings of the Committee to the Association, they would respectfully 
recommend the adoption of the plan proposed, and, suggest that they be authorized to 
complete the narrative and memoirs in question, and to transmit them to the Com- 
mittee ofPublication. * 

To E. L. Beadle, M. D., Secretary. JOSEPH M. SMITH, M. D., Chairman. 

New York, April 24, 1554. 

The letter from Dr. John G. Adams, dated Marseilles, March 19, 1854, was again 
read. On motion, the request was ordered to be complied with. 

Dr. Atlee, of Pennsylvania, here made the explanation that the volumes of the 
Transactions had been forwarded very recently. There not being any of the first 
edition on hand at the time the order was received, the Committee were obliged to 
wait until the issue of the second edition. 

The following resolutions passed at the annual meeting of the New Hamp- 
shire Medical Society were read. 

At the Annual Meeting of the New Hampshire Medical Society, holden at Concord, 
June 1, 1853, the following Resolutions were unanimously adopled : 

Resolved, That it is the decided opinion of the New Hampshire State Medical Soci* 
ety, that no Delegate should be admitted to membership in the American Medical As» 
eociation, who represents a Medical Society which numbers among its members any 
person or persons who adopt as their system of practice, any form of empiricism. 

Resolved, That the Secretary of this Society be instructed to transmit a copy of this 
resolution to the Secretaries of each of the State Medical Societies, and to the Secre- 
taries of the American Medical Association, previous to their next Annual Meeting. 

E. K. WEBSTER, Secretary N. H. Medical Society. 

Boscawen, June, 1853. 

Dr. Gross, of Kentucky, offered the following resolution, which being seconded* 
was ordered according to the rules of the Association, to lie upon the table for one 
year before being acted upon. 

Whereas, It is of great importance to the harmony and good feeling of this Associa- 
tion, that its presiding officer should be fully acquainted with parliamentary usages, 
and the mode of presiding over deliberative bodies; Therefore 

Resolved, That that part of the Constitution which relates to the election of officers, 
be so amended, as that the election shall take place immediately before the adjourn- 
ment of each meeting, instead of immediately after its commencement. 

Dr. Gross offered another resolution, declaring it to be disorderly for any future 
Committee of arrangements to prepare a costly supper or dinner, for the entertain-* 



1854.] American Medical Association. 285 

ment of the members of the Association. Dr. Gross remarked in support of the reso- 
lution, that he had the misfortune, perhaps, to live in a small city, where the profes- 
sion was poor, and unable to go to any extravagant expenditure in the entertainment 
of the Association, in case it should ever honor his city by holding its meetings there. 
His resolution, he further said, was prospective in its application, and intended to 
make no reflection on any arrangements that had been made by the profession of this 
city. 

A warm and spirited debate sprung up on the resolution, in which Drs. Coons 
McPheeters and Barnes participated. 

Dr. Coons approved of the resolution, and the objects it was intended to effect. The 
cause of science could hot be promoted by preparing costly dinners at great expense. 
The Committee of arrangements in this city, have been at great expense and trouble 
to make preparations for the reception of the Association, and he thought such efforts 
and receptions did not tend greatly to forward the ends of the Association. (These 
remarks elicited some decided evidences of disapprobation.) 

Dr. McPheeters deprecated the expediency of dragging such matters before the 
Association. 

A motion to lay the resolution on the table was lost. 

An amendment was then offered by Dr. McPheeters, striking out the word " disor- 
derly," arid substituting a clause, which modified the resolution, so as to request future 
Committees of arrangement not to prepare costly entertainments for the Association. 
. Dr. Mcllvaine desired to amend further by a clause prohibiting the use of liquor 
and tobacco. After some further discussion, Dr. Gross' resolution, with Dr. McPhee- 
ters' amendment was carried. 

The nominating Committee then entered, and through their Chairman, Dr. White, 
of New York, reported the following officers for the ensuing year. 

For President — Charles A. Pope, of Missouri. Vice-Presidents — E. D. Fenner, of 
Louisiana; N. S. Davis, of Illinois; William Wragg, of South Carolina; John Green, 
of Massachusetts. Secretaries — Edwin S. Lemoine, of Missouri ; Francis West, of 
Pennsylvania. Treastcrer — D. Francis Condie, of Pennsylvania, 

The Export was accepted unanimously, and the gentlemen nominated declared to 
be duly elected. 

Drs. D. H. Storer, of Massachusetts ; White, of New York ; Brainard, of Illinois, and 
Eve of Tennessee, were appointed a" Committee to conduct the newly elected offi- 
cers to their seats. 

Dr. Pope being absent on account of sickness in his family, the Senior Vice-Presi- 
dent, Dr. Fenner, presided, and expressed his thanks for the honor conferred, and 
regretted the absence of the President. 

The Chairman then stated that owing to some informality in transmitting the reso- 
lution instructing the nominating Committee to select a place for the next annual 
meeting, the Committee had not acted thereon. It was then moved and adopted 
unanimously, that the City of Philadelphia be selected for holding the next meeting of 
the Association. 

A series of resolutions were then reported from the committee on publication, to which 
an amendment was offered, providing that a fee of three dollars should be required 
of each member annually, to defray the expense of publishing the transactions of the 
Association, and that the name of any member refusing or neglecting to pay the same, 
should be erased from the list of permanent members. A spirited and interesting de- 
bate sprung up on the amendment. 

Dr. A flee supported the amendment, saying it was onlv asserting in theory, what 
37 



286 American Medical Association. [June^ 

had always been the practice of the Association. The opposers of the amendment 
asserted that absence, accident, or circumstances beyond the control of a member, 
might prevent him from paying his due, in which case, it would be manifestly unjus* 
to strike out his name. 

"Dr. Mcllvaine approved of the amendment: it would make members mo»e prompt! 
and punctual in the payment of their dues. 

During the discussion, a motion that the resolutions be acted on separately was lost» 

The resolutions were then further amended by providing that the Secretary, before 
erasing the name of a member, should inform him of his indebtedness, and in this- 
form passed en ?/iasse, by a unanimous vote. 

Dr. Atlee, on behalf of the Committee to procure a stone with a suitable inscription 
for the "Washington monument, reported that he had adopted, at the suggestion of 
the lamented Dr. Pierson, of Salem, the design for the stone, representing Hippocrates 
refusing the presents of King Artaxerxes, who invited him to go to Persia and succor; 
the enemies of Greece. The sculpture was on beautiful marble, by Samuel Beck, a 
yoijng artist of Lancaster County, Pennsylvania, from a daguerreotype copy of Viardot's 
celebrated picture, presented to him by Miss Abby L. Pierson. The execution of the 
work js in the highest style of the art, and evinces extraordinary talents in the artist. 

The stone is of Vermont marble. The resolution authorizing the movement was 
adopted at Richmond. There was a lack of funds for the accomplishment of this ob^ 
ject to the amount of $400, and members of the Association were respectfully invited 
to contribute, as they felt inclined, and make up the amount. 

At the conclusion of Dr. Atlee's remarks, the members gathered around him to con- 
tribute to the sum required to complete the work. 

On motion of Dr. White of New York, Dr. Charles Hooker of Connecticut, was ap- 
pointed Treasurer, pro tern., Dr Condie being absent. 

Dr. N. S. Davis, of Illinois, moved the following resolutions, which were adopted. 

Resolved., That all motions and resolutions made to the Association shall be present- 
ed in writing and signed by their mover. 

Resolved^ That no member be allowed to speak more than fifteen minutes at one 
time, nor more than once on the same subject, until all have spoken who wish to do so. 

A gentleman now announced that Dr. Pope, the President elect, was in the room. 

Two of the Committee appointed for that purpose then escorted the President to the 

chair. He addressed the Association in a few words as follows — 

Gentlemen — There are occasions when the mouth is dumb, because the heart is 
full. I am unequal to the. task of thanks. Honor, which is valuable according to its 
source, is in the present case great indeed, for I behold around me the members of a 
noble profession, the cultivators of a yet nobler science, gathered from the wide extent 
of our beloved country. 

I woujd that this undeserved and unexpected honor had fallen upon one older and 
worthier than I, for many such I see before me. In one thing only will I claim 
equality, for however unworthy in other respects, I yield to none in ardent devotion 
and ceaseless love to our time honored art. But I will not claim more than I ought. 
Nor do I misoonsti ue the honor which your partiality has conferred upon me : for well 
1 feel that it was intended less as an individual compliment, than as one to th^ West 
in general, and to Missouri especially. In this view, and for them, and for myself, I 
)eturn you the warm, unfeigned thanks of a grateful heart. Relying upon your par- 
tiality, which has thus elevated me to my present position, and claiming indulgence 
for any short-comings in presiding over your deliberations, I shall endeavor to acquit 
myself to the best of my poor ability. Again, Gentlemen, I thank you. 

Dr. Store r of Boston, now informed the Association that Dr. Ninian Pinckney one of 
\he Delegates from the United States Navy was present, and \£ould be glad if per,mis- 
sgioji were granted him to address the meeting. < 



185-1.] American Medical Association. 287 

The request was acceded to, and Dr. Pinckney addressed the As?ociation as follows. 

Having been deputed by the present distinguished head of the Bureau of Medicine 
and Surgery (the successor of the venerable Harris, whose name stands deservedly 
high as an ornament of the profession which his great talent and extensive acquire- 
ments have so long and happily illustrated, and whose place has been supplied by a 
gentleman of the very first qualification for the office), it is my privilege to congratu- 
late my brethren here assembled in the heart of the great and magnificent West, and 
mingle in their deliberations — deliberations that have for their object the elevation and 
efficiency of the medical profession of the United States. There seems to be a pecu- 
har s fitness in the place of our assembly. St. Louis is a name too dear to every Ame- 
rican citizen to require any eulogy at my hands. The beauty of her location, her 
commanding influence as the great commercial emporium of the West, her futures 
boundless career of usefulness and honor, carried otit in a measure by the talent and 
enterprise of her citizens — all concur to make her a most appropriate place for the 
convening of such a body as I see before me. I may therefore offer you my congrat- 
ulations upon the time and the place, satisfied that whatever tends to exalt science 
and dignify and ennoble the condition of man, will meet no where a more cordial sym- 
pathy or enlightened public sentiment. 

In the discharge of my appropriate duty, it will be necessary to remind you that 
your kind sympathy and earnest co-operation with your brethren of the Navy have 
already produced the most admirable and desirable results. Twice have the Senate 
of the United States passed a law conferring rank upon our corps perfectly congenial 
with our feelings and commensurate with our just rightg. You are aware that a bill 
for the reorganization of the Navy is now before Congress. The Hon. Secretary of 
the Navy, in a spirit that reflects infinite credit upon his sense of justice, and displays' 
his broad and enlightened appreciation of public policy, and with a view of harmoniz- 
ing the several branches of service, appointed the Chief of the Medical Bureau and a 
Commander to represent the line and staff officers of the Navy. Their report, satis- 
factory to both parties, received the cordial approbation of the Secretary, and was by 
him sent to the chairman of the committee on Naval Affairs in the House. The re- 
port was accepted by the cammittee and is now incorporated into the bill for re-organ- 
ization. Your report, adopted at your last session in New York, and the recommen- 
dation of your own distinguished committee, laid before the Republic of our great and 
growing confederacy, have been chiefly instrumental in securing this measue of relief 
to your brethren of the Navy. I, as their representative, tender you my own and their 
thanks for your manly and efficient action in the premises. We will not doubt that 
Congress, in responding to your wishes, now clothed with the efficient sanction of the 
Secretary of the Navy, founded upon the joint report of the two representatives of the 
line and staff officers, will be prompt to measure out to Us the relief we need, and en- 
graft upon the legislative proceedings a principle which must commend itself to every 
calm and unprejudiced friend of the Navy. 

I may have been deemed importunate by some in pursuing with so much earnest- 
ness my appeal to your sympathy; but I have studied the elements of the medical 
profession-and the feelings of the American people to but little purpose, if importunity 
be not deemed a virtue when official honor and dighity are the objects of pursuit. 

I have now discharged the specific duty assigned me as the representation of the 
Medical officers, of the Navy in a matter personal to themselves, yet of high concern- 
ment to you all. Our honor is your honor; our dignity your dignity; our rights your 
rights. This noble sentiment you have unfurled to the gaze of the world, and we are 
here to thank you for it. You will allow me to say in return, that your honor is our 
honor, your dignity our dignity, your rights our rights. We shared with you the sin- 
cerity and concern that attended your first celebration, when many were desponding 
and not a few inert and inactive. We had a strong hope that the advancement of 
the science and the exaltation of our profession would be thereby promoted. We 
knew that in union there was strength, and that concert of action would be produc- 
tive of a rich golden harvest, and the sight that this day greets my eye, and the expe- 
rience of the past, conclusively proves that in this hope we were not doomed to be 
disappointed. 

Gentlemen, you stand upon a lofty eminence — linked by all the ties of brotherhood. 
Assembled to work, not for the vain and idle purposes of a fleeting hour, butfor future 
ages, you must command the respect and admiration of the world. Personal gratifi- 
cation, personal emolument, personal feeling and private convenience, are all cheer- 
fully sacrificed for the common good. 



288 American Medical Association, [June^ 

In this peaceful though earnest conflict of mind with mind, this blending of calm de- 
liberation with the suggestions of thought, which are accustomed to explore all the 
heighth and depth of scientific investigation, there must be imparted an increased sti- 
mulus to exertion, and a happy exemption from that low and vulgar jealousy which 
has done more to lower the profession of medicine than aught else beside. 

I bid you all hail in this onward and upward career, I come to cheer on your delib- 
erations and participate in your self sacrificing efforts to raise the standard of medical 
proficiency; to witness the triumph of talent and argument— not to add anything of my 
own; and I shall carry back to my brethren of the Navy, the cheering intelligence 
that union characterized all your proceedings, and efficiency all your actions. You 
will excuse me if, in my visions of future recollection and honor, I recall, for the ex- 
pression of our mutual sympathy and condolence, the familiar forms of those who took 
a prominent part in the doings of our last Association, and parted from us with high 
hopes and exulting pride; but who, alas! were crushed by the hand of death ere they 
reached their homes, or were greeted by the smiles of their admiring friends. The 
calamity that put an end to their bright career, fell with stunning suddenness upon the 
heart of the whole country. All felt that bright lights were extinguished in the social 
and professional circle, and all sympathized with us, who best knew the extent of the 
sad bereavement. Let us build a monument to their memory. They fell in the pro- 
secution of what they, in the noble spirit of chivalry which encircled them, considered 
a paramount duty. Let it never be said that, while we are yearly occupied in erect- 
ing a monument of enduring renown to the profession at large, we are so engrossed 
with the thrilling and moving scenes of active life, as to forget what is due to death, 
to such a death, encountered in such a cause. While we write upon the tablet of 
memory those simple words, "requiescat in pace," let us engrave upon the solid marble 
our sense of the magnitude of our loss; and show to the world that the living stars of 
the profession know what is due to the illustrious lights that have gone out — gone out, 
did I say ? not so ; they can never go out, for the rays of their glory still linger among 
us to cheer us on in our future career. 

A communication was read from L. M. Kennett, Ex-Mayor of St Louis, inviting all 
the members of the Association to his residerfce that evening. 

Also one from Rev. William G. Elliot, President of the Missouri Institution for the 
Blind, requesting the members to visit at their convenience before leaving the city, 
that establishment. 

On motion of Dr. Atlee, of Pennsylvania, the Committee on Nominations was in- 
structed to report to the Association all the Standing Committees. 

The President invited the members to the residence of Drs. Moore, McPheeters 
and Reyburn. 

On motion the Convention adjourned. 

May 3 — morning session. 

The Association met at 9 o'clock, and after the reading of the minutes, which were 
slightly altered, they were adopted. The hour of adjournment on motion, was fixed 
for this evening, at 4 o'clock. 

l)r. Atlee of Pennsylvania, moved that the memorial to the Association from the 
American Medical Society of Paris be read, which was carried, and the Secretary 
read as follows. 
To the American Medical Association ; 

We, the Members of the American Medical Society of Paris, beg, through our dele- 
gates, to present the following memorial: 

The National Association of the United States, has' had its origin mainly from the 
consciousness of physicians of the low state of medical education in our country, and 
from the desire universally entertained by them, of elevating the standard of medical 
education and attainment of the medical profession. 

We, by our sojourn abroad, from an intercourse with those educated here, have be« 
come more painfully conscious of our infirmities and deficiencies at home, and for this 
reason beg once more, to urge upon the Association the necessity ol a change. While 
acknowledging; however, the superiority of education in Europe, we are far from de» 



1854.] 



American Medical Association, 289 



siring to arrive at equality by imitating their methods. We therefore beg to urge the 
following plans for the consideration of the Association: 

That in each Stale there be appointed by the Medical Society of the State, a "Board 
of Examiners, which board shall be chosen every year from members of the Society, 
and which shall perform its duties the following year, in the place and immediately 
before the sitting of the Society ; that their examinations be public, and that any one 
whosoever may apply who shall be introduced by a member ot the Society, and that 
no one can hereafter become a member of the State Medical Societies, nor of the 
American Medical Association, who has not the certificates of having satisfactorily 
passed such examination. 

As to the qualifications to be required of the candidates, we do not think it advisa- 
ble to enter into particulars. They should not, however, believe in any peculiar doc- 
irines or methods — no certificates of attendance upon courses of lectures should be 
necessary, but solely the possesion of the necessary amount of medical knowledge to 
practice their profession with safety and honor. 

This plan in no way interferes, with the established schools, its effect upon them 
could only be salutary. Students would attend those institutions where those branches 
of a medical education that can only be acquired by attendance upon lectures, are best 
taught. 

All of which is respectfully submitted to the consideration of the Association. 

DR. HAMMER, St. Louis, > 

Pans, March 21st, 1S54. . DR. MURPHY, Cincinnati, J 

The memorial was referred to the Committee on Publication. 

The President now announced that the next business in order was the receiving of 
the reports of Standing Committees. 

Several Committees were continued on account of the absence of the Chairman, 
viz : Drs. Condie, of Pennsylvania, Arnold of Georgia, Hooker of Connecticut, Jones 
of Louisiana, Wood of New York, Porcher of South Carolina, Wilson ot Virginia, Lee 
of New York, Engleman of Missouri, Bullitt of Kentucky, Campbell of Georgia, Bol- 
ton of Virginia, Taylor of Michigan. 

Dr. R. S. Holmes, of Missouri read a synopsis of his report on Epidemic Erysipe- 
las. The report was referred to the Committee on Publications. 

Dr. Wood of Philadelphia, through Dr. Carson asked to be excused from serving 
on the committee which was granted. 

Dr. John L. Atlee was not quite prepared to report and was granted further time. 

An abstract ot the report of Dr. D. J. Cain of S. C. was read by Dr. Wragg, who stated 
that the report needed some slight alterations to complete it. On motion it was re- 
ferred, when completed, to the Committee on publications. 

Dr. F. A. Ramsey of Tennessee, presented a partial report of Dr. W. L, Sutton 
of Kentucky, on Epidemics of Tennessee and Kentucky for the last year. The report 
was referred to the Committee on Publications and Dr. Sutton continued on the Com, 

Dr. Reyburn of Missouri asked for further time. Granted. Dr. George Menden- 
hall of Ohio gave a synopsis of his report on Epidemics of Ohio, Indiana and Michi- 
gan. Referred to the Committee on Publications. 

Dr. Fenner of Louisiana, stated that owing to his not receiving information of his 
appointment until recently, he had not been able to finish his report. He then pre- 
sented to the Association his history of Yellow Fever in New Orleans during the year 
1853, and also read an abstract of his unfinished report upon Cholera. Dr. Fenner 
was requested to finish his report and transmit it to the Publishing Committee. 

Dr. Mussey here moved that these reports of the Standing Committees be suspend- 
ed to allow Dr. M. L. Linton of Missouri to present certain views which he entertain- 
ed in regard to the pathology and causes of Yellow Fever. The request was granted, 
and Dr. Linton then endeavored by an able argument to prove the identity in cause 
and nature of Yellow, Bilious, and other so-called miasmatic fevers. 



290 American Medical Association. [June ? 

Dr. Blatehford of New York, moved that Dr. Linton be requested to draw up a pa- 
p*sr expressive of his views, and present it to the Publishing Committee. Carried. 

Dr. Brainerd requested further time to make up a full report upon the constitutional 
and local treatment of Carcinoma. 

Dr. N. S. Davis, of Illinois, on the influence of local circumstances on the origin and 
prevalence of Typhoid Fevef, read a brief abstract of his report. Referred to Com- 
mittee on Publications. 

Dr. F. Donaldson of Maryland not being present, a communication was read from 
him, stating that he had completed his report upon "The present and prospective va- 
lue of the Microscope in Disease," and asking that it be referred to the Committee on 
Publications. Granted. 

The report of Dr. R. L. Howard, of Columbus, Ohio, upon the pathology and treat- 
ment of Scrofula was called for, when his death was announced by a colleague. 

A letter was read by the Secretary from Dr. Cabell of Virginia, who had been sub- 
stituted as chairman on the Committee on Education, instead of Dr. B. R. Wellford, 
stating that his report was ready, but owing to his recent appointment he had not been 
able to obtain the aid or views of his colleagues, and therefore the report presented 
was expressive of his opinions only. At his request it was referred to the Publishing 
Committee. 

Dr. Wragg, of S. C, one of the Vice Presidents, took the chair, and Dr. Pope as 
chairman of Committee on volunteer communications made a report as follows. 

Mr. President: The Committee on Prize Essays and Volunteer Communications, 
respectfully report that the Essays submitted to their consideration were nine in num- 
ber, of which one was presented as a volunteer communication. Thelcommittee 
have carefully examined the whole of these Essays and bestowed upon them the at- 
tention which a sense of the importance of ihe duty assigned them imposed. They 
feel free to say that some of these Essays possess undoubted merit, both in matter and 
style, and they admit in them evidence of high scientific attainment, as well as a fa- 
miliarity with the graces of composition. But whilst cheerfully according these claims 
to their authors, the committee have preferred to be governed in their choice by con- 
siderations of originality and practical import, rather than of mere theoretic specula- 
tion, however finely portrayed. The committee, have, consequently, concluded to 
award but a single prize. The Essay selected is entitled "An Essay on a new me- 
thod of treating ununited Fractures and certain Deformities of the Osseous System." 
It bears a motto in French, which being liberally rendered in modern English, reads, 
"and notwithstanding all the pains I have heretofore taken, I have reason to praise God, 
in that it hath pleased Him to call me to that branch of medical practice commonly 
called Surgery, which can neither be bought by gold nor by silver, but by industry 
alone and by long experience." 

If it please the Association I will now break the seal of the packet superscribed by 
the same motto, and declare the name of the successful competitor. 

Dr. Pope then broke the seal of the packet endorsed by the same motto, and an- 
nounced the name of Dr. Brainerd, of Chicago, Illinois. The announcement was greet- 
ed with applause, and on motion Dr. Brainerd was invited to the stand to explain 
his new mode of treating ununited fractures. 

Dr. Hooker, Treasurer, pro tem, c: lied the attention of the Association to the resolu- 
tion adopted yesterday, in reference to the annual assessment — the prompt payment 
of which he urged, and recommended the appointment^ Committees in each State to 
attend to the sale and distribution of the Transactions of the Association. He also 
gave notice that he was prepared to receive payment for Vol. 6th of the Transaction's. 

Dr. Elbert, of Iowa, offered the following resolutions. 

Resolved, That a committee of- — members be appointed to recommend to the next 
annual meeting, any amendments, necessary in their opinion, to the Constitution of 
By Laws of the Association. 



1854.1 American Medical Association. 29 X 

Resolved That this meeting instruct said Committee to report a Constitution and By- 
Laws which shall require the election of officers, and the place of holding ttie annual 
meetings to be determined by ballot, and without the intervention of nominating com- 
mittees. 

These resolutions gave rise to considerable discussion and were finally lost. 

On motion of Dr. C. B. Guthrie of Kentucky, it was unanimously 

Resolved, Thatin the Sectelary of the Treasury's recommendation to Congress to abol-. 
ish, or materially modify the duty on such crude drugs not producable in this country, 
as are used in the laboratories of the country in the manufacture of chemicals, we re- 
cognize a wise provision for the further protection or the profession, and the commu-. 
niiy at large from impure and sophisticated medicines. 

Resocved, That a copy of this resolution be signed by the proper officers of this As- 
sociation and transmitted to the Secretary of the Treasury, and to the Committee of 
Ways and Means in Congress. 

Dr. J. B. Johnson, of St. Louis, Mo., now read the following letter: 
To the American Medical Association assembled at St. Louis: 

Mr. President — At the last meeting of the Association in New York, I presented 
the following preamble and resolution through my friend Dr. Stewart, of New York, 
which, with some amendments, were laid on the table. 

As we are constantly called upon to deplore the ravages of death among the me- 
ritorious and worthy members of our profession throughout the United States. 

Resolved, That a Standing Committee be appointed by this Association to procure 
memorials of the eminent and worthy dead among the distinguished physicians of our 
country, and present them to this Association for publication in their transactions. 

I now beg leave to call up the resolutions through my friend Dr. J. B. Johnson, of 
St. Louis. The medical biography of our country is intimately related to the history 
of it, as the lives of eminent men are identified with the history of the times in which 
they lived. In the United States there have been and are to be found, medical men whose 
lives and actions are ornaments.to human nature, and whose brilliant career in the 
cause of humanity and science, reflect honor and dignity upon our country. We 
sutler nothing in this respect, in comparison with the learned and eminent physicians 
of Europe. The profession of medicine contains more learned and distinguished men 
than any other profession or calling, and some memorial of their lives and actions 
should be presented to the world in a more durable form than the periodical journals 
of the day, and particularly of the newspaper press. A more permanent and proper 
place for the publication of such memorials would be in the Transactions of the Ame- 
rican Medical Association. And without disparagement to any other articles which 
have heretofore been published in the Transactions, such memorials would be read 
by the surviving members of the profession with great interest and improvement— 
short biographies need take up but little room in the publication — and this objection 
to the proposed movement may be thus obviated. 

We are constantly noticing that death spares no ranks or conditions of men. Those 
who contend most skillfully against his insatiate ravages, themselves fall victims to 
his all conquering sword. Within a very short space of time, we have been called to 
lament the deaths of Dr. Nathaniel Chapman, the former President of this Associa- 
tion; of Drs. Samuel G. Morton, William E. Horner, Isaac Parrish, G. S. Pattison, J. 
Kearney Rodgers, Daniel Drake, the great Medical Pioneer of the West ; Samuel Mc- 
Clellan, Amos Twitchell, Abiel Pierson, G. C. Sha^tuck, Archibald Welch, and very 
many others which time will not permit me to enumerate. 

This is not the place to speak their eulogies; some permanent notice of them and 
of many others who have recently died, should be published in the Transactions of 
this Association, where the useful improvements and discoveries of the living should 
be recorded, and the memories of the worthy dead should be presented. 

STEPHEN W. WILLIAMS, late of Deerfield, Mass. 

Lavina, Winnebago co.,, 111. 

The resolutions, on motion of Dr. Johnson were adopted. 

Dr. Mcllvaine, of Ohio, offered the following resolution : 

Resolved, that in the opinion of this Association the practice of professors reading 
lectures to their classes, no matter with how much care selected from the musty re- 
cords of antiquity, is a miserable apology for teaching-^is prima facise evidence of their 
jnaptness to instruct, and is inimical to medical progress. Laid on the table- 



292 American Medical Association. [June, 

Dr. Nagle, of Ohio, proposed that the words "-Surgical instrument," be erased from 
chapter 2d Art. 4th of the code of ethics. The motion was lost. 

Dr. F. A. Ramsay offered the following amendment to the Constitution which by 
the laws lies over to the next meeting. 

Resolved, That the Constitution of this Association be so amended as to dispense 
with the nominating Committee, and the duties of such Committee. 

Dr. S. H. French, of New York, submitted the following, which was carried. 

Resolved, That a Committee of three be appointed to enquire what state or other 
society represented in this Association, are in fellowship with irregular practitioners. 

A communication was presented by Dr. Blatchford, of New York, from Dr. Spore, 
of the same state, on the subject of hydrophobia and its connection with the season. 
As Dr. Spore was not a member of the Association, Dr, Blatchford was on motion, 
appointed Chairman of a Committee on hydrophobia. 

Dr, Joseph N, McDowell submitted the following resolution. 

Resolved, That a Committee be apointed to investigate the improvements in in- 
struments for lithotomy, by Nathan R. Smith, Paul F. Eve, and Dr. McDowell. 

The resolution after some discussion was laid on the table, 

Dr, Ramsay, of Tennessee, made the following motion, which was adopted. 

Resolved, That a Committee be appointed who shall be charged with the duty of 
investigating the charges made against gentlemen in fellowship with this Association, 
of sustaining proprietary medicines by certificates or otherwise, 

Dr, S, M, Smith, of Columbus, Ohio, offered the following resolution, 

Resolved, That a Standing Committee of be appointed by this Association on 

the subject or Insanity, as it prevails in this country, including its causation as heredi- 
tary transmission, educational influences, physical and moral, social and political in- 
stitutions, &c, Its forms and complications, curability and means of cure a*nd pre- 
vention, fee. Carried. 

An invitation was now received from Col, John OTallen, for all the members of the 
Association to an entertainment at his country seat, at 5 o'clock this evening. 

On motion, the Convention then adjourned, 

AFTERNOON SESSION — May 3. 

At 3 o'clock Dr. Wragg, one of the Vice-Presidents, called the Covention to order, 
and stated that the President would not be present during the afternoon. 

Dr. White, of New York, offered the following resolution which was unanimously 
adopted. 

Resolved, That the thanks of this Association be presented to Dr. J. Knight, the late 
President, for the very dignified, courteous, and efficient manner in which he presi- 
ded over its deliberations, and that he be requested to furnish the usual address for 
publication, 

The thanks of the Convention were also voted to the late Vice-Presidents, Drs. 
Parsons, Frost, &c, and the late Secretary, Dr. Beadle. 

The Secretary then read a report from Dr. George J. Zeigler, of Philadelphia, from 
the special Committee, authorized at the last meeting to report on a plan for a more 
general, systematic, and thorough investigation of subjects connected with medical 
science, concluding with the following resolution. 

Resolved, That the American Medical Association herebv recommends all medical 
societies to establish in accordance with the plan detailed in the report, special Com- 
mittees for the selection, investigation, collaboration, and publication, of all subjects 
of interest connected with medical science. 

On motion, the report with the resolution accompanying it, was referred to the 
Committee on Publications, with directions to publish them in the Transactions. 

Dr. Atlee stated that he had just received a letter from Dr. Parrish ; Chairman of th© 



185-4.] American Medical Association. 293 

Committee on the Epidemics of New Jersey, informing him that his report was not 
yet finished, and asking leave to send it to the Publishing Committee, when finished, 
for publication. Granted. 

Dr. Davis, of Illinois, presented to the meeting some specimens of milk, prepared 
in New York, so as to make a voyage of any distance without losing any of its nutri- 
tive qualities. This milk he stated, would if used, prevent many of the diseases of 
children to which they are subjected by the use of impure milk, ,. 

On motion, the Association adjourned to meet at 9 o'clock on Thursday morning. 

MORNING SESSION — May 4. 

Convention met pursuant to adjournment, at 9 o'clock, Dr. Pope in the Chair. 

Dr. Seviter, of Iowa, one of the nominating Committee, having left the city, the or 
der of business was suspended in order to allow another to be substituted. On mo- 
tion, Dr. McGugin was appointed. The minutes of yesterday were then read, cor- 
rected, and adopted. 

Dr. McPheeters, of St. Louis, stated to the Association that arrangements had been 
made with all the different Railroad Companies of the country, excepting the New 
York and Hudson River Railroad Company, to convey the Delegates who exhibited 
through tickets to St. Louis, a passage back free of charge. 

The Chairman of the nominating Committee requested the members of said Com- 
mittee to meet in an adjoining room. 

A communication was read tendering the hospitality of the city of Burlington, 
Iowa, to those members returning by the upper Mississippi. 

Dr. Atlee moved that a copy of the Constitution of the Association be hereafter ap- 
pended to each volume of the Transactions. Adopted. 

The following resolution, offered by Dr. Gross, of Kentucky, was adopted, and Dr. 
Gross appointed on the Committee. 

Resolved, That a Committee of one be appointed by the Chair, to inquire into the 
causes which obstruct the formation and establishment of our National Medical Liter- 
ature, and to report on the subject at our next regular meeting, or as soon thereafter 
as practicable. 

The following letter was read by the President— 

Dr. Washington, Chairman of Committee of Arrangements; , ,, 

Dear Sir — I am authorized by the Directors of the Pacific Railroad, to offer to your 
Committee the use of the road, at your convenience, in case you should desire to show 
to the members ofthe Medical Society that are expected to meet here, the country in 
the neighborhood of St. Louis, and go a few miles out on what we hope will in time 
be, the road to the Pacific Ocean. 

If you will give me one day's notice, T will send out a special train, at such an hour 
as may suit your arrangements. Very respectfully, 

THOMAS S. O'SULLIVAN, Eng. and Sup't. 

On motion of Dr. Atlee, a vote of thanks was extended to the Directors ofthe Pa- 
cific Railroad — the invitation accepted, and the time fixed at 10 o'clock, A. M. on 
Friday. 

The following resolution, offered by Dr. J. B. Linsley, of Tennessee, after some 
debate was referred to the Committee on Medical Education, with instructions to 
report thereon at the next annual meeting. 

Resolved, That this Association earnestly recommend to the few western schools 
which still retain the rule of making four years practice equivalent to one term at 
College, the abrogation of said rule, as holding out strong inducement and temptation 
to young men, to enter upon the practice of medicine with little or no preparation. 

Dr. Paul F. Eve, of Tennessee, submitted a resolution, which, after a slight amead- 
ment, was adopted as follows — 

38 



£94 American Medical Association. [June, 

Resolved, That a Committee of three be appointed by the Chair, to report at the 
next annual meeting,the best means of preventing the introduction of disease by em- 
igrants, into oUr country. Drs. S. H. Dickson, J. H. Griscom, and E. D. Fenner, Com- 
mittee. 

Dr. Linton of St. Louis, offered this resolution, which was referred to the above 
Committee. 

Resolved, That in the opinion of this Association, quarantine establishments afford, 
no protection to states and cities against the invasion of epidemics, such as cholera 
and yellow fever. 

Another motion of Dr. Linton's, to take the sense of the Convention upon the utili. 
ty of quarantine, was laid on the table. 

Dr. Sayre, ofNew York, made a motion to withdraw from the Committee on Medi- 
cal Education, the memorial from the American Medical Society at ParK Dr. Sayre 
warmly supported the object of the resolution. A spirited discussion arose, in which 
Dr. Atlee, of Pennsylvania, Dr. Edgar, of St. Louis, Dr. Elbert, of Iowa, Dr, Mcllvaine, 
of Ohio, and Dr. Paddock, of Illinois, participated. 

The memorial was finally, by a large majority, withdrawn from the Committee, and 
laid on the table. 

A communication was received from Dr. Peebles, of Petersburgh, Va., asking to be 
excused from serving on the Committee on Epidemics of Virginia and North Carolina. 
Granted. 

Dr. Phelps, of New York City, asked and obtained leave to read an abstract of a 
paper upon the relation between medicine and religion. 

The nominating Committee at this juncture appearing, the regular order of business 
was suspended, to allow their report. 

REPORT OF COMMITTEE ON NOMINATIONS. 

The Committee of nominations, in fulfilling the duty imposed upon them, recom- 
mend the continuance of several of the Special Committees previously created, and 
tne appointment of some new ones. They therefore, submit the following list of Chair- 
men of Special Committees, with the subjects to them committed ; 

Dr. Worthington Hooker, of New Haven, Conn. — On epidemics of New England 
and New York. 

Dr. John L. Atlee, of Lancaster, Penn. — On epidemics of New Jersey, Pennsylva- 
nia, Delaware and Maryland. 

Dr. D. J. Cain, of Charleston, S. C. — On epidemics of South Carolina, Florida, Geor- 
gia, and Alabama. 

Dr. W. L. Sutton, of Georgetown, Ky. — On epidemics of Tennessee and Kentucky. 

Dr. Thomas Reyburn, of St. Louis, Mo.— On epidemics of Missouri, Illinois, Iowa 
and Wisconsin. 

Dr. George Mendenhall, of Cincinnati, Ohio. — On epidemics of Ohio, Indiana and 
Michigan. 

Dr. E. D. Fenner, of New Orleans, La. — On' epidemics of Mississippi, Louisiana, 
Arkansas and Texas. 

Dr. James Jones, of New Orleans, La.— On the Mutual Relations of Yellow and 
Bilious remittent Fevers. 

Dr. D. F. Condie, of Phila. — On the Causes of Tuberculous Disease. 
. Dr. Joseph Leidy, of Phila. — On Diseases of Parasitic Origin. 

Dr. A. P. Merrill, of Memphis, Ten n.— On Physiological Peculiarities of Diseases 
of Negroes. 

Dr. Joseph N. McDowell, of St. Louis, Mo. — On Statistics of the Operation of re- 
moving Stone in the Bladder. 

Dr. F. Peyre Porcher, of Charleston, S. C. — On the Toxicological and Medicinal 
Properties of cryptogamic plants. 

Dr. Daniel Brainard, of Chicago, 111. — On the Constitutional and Local Treatment 
of Carcinoma. 

Dr. George Engleman. of St. Louis, Mo— On the Influence of Geological Forma= 
tion on the Character of Disease. 



1854.] American Medical Association. 295 

Dr. Henry Taylor, of Mt. Clemens, Michigan.— On Dysentery. 

Dr. Horace Green, of New York. — On the use and Effects of Applications of Nitrate 
of Silver to the throat, either in local or general Disease. 

Dr. P. Claiborne Gooch, of Richmond, Va. — On the Administration of Anaesthetic 
Agents during Parturition. 

Dr. Charles Hooker, of New Haven, Conn. — On the Diet of the Sick. 

Dr. E. R. Dabney, of Clarksville, Tenn. — On certain forms of eruptive fevers preva- 
lent in Middle Tennessee. 

Dr. Sanford B. Hunt, of Buffalo, N. Y. — On the hygrometrical state of the atmos- 
phere in various localities, and their influence on health. 

Dr. Frank H. Hamilton, of Buffalo, N. Y. — On the frequency of deformities in frac- 
tures. 

Dr. M. M. Pallen, of St. Louis, Mo. — On puerperal convulsions. 

Dr. G. S. Walker, of St. Louis, Mo. — On diseases of the prostate gland. 

Dr. H. A. Johnson, of Chicago, 111. — On the excretions as an index to the organic 
changes going on in the system. 

Dr. Leroy H. Anderson, of Sumterville, Ala. — On Typhoid Fever and its Com- 
plications, as it prevails in Alabama. 

Dr. W. H. Byford, of Evansville, la. — On the Pathology and treatment of Scrofula. 

Dr. N. S. Davis, of Chicago, Illinois. — On the Nutritive Qualities of Milk, and the in- 
fluence produced thereon by pregnancy and menstruation in the human female, and 
pregnancy in the cow; and also on the question whether there is not some mode by 
which the nutritive constituents of milk can be preserved in their purity and sweet- 
ness, and furnished to the inhabitants of cities in such quantities as to supercede the 
present defective and often unwholesome methods of supply. 

Dr. E. Bl Haskins, of Clarksville, Tenn. On Microscopical Investigations of Ma- 
lignant Tumors. 

Dr. George R. Grant, of Memphis, Tenn. — On the Sulphate of Quinia as a remedial 
agent in the treatment of fevers. 

Dr, R. R,Mdlvaine, of Cincinnati, Ohio, — On the Study of Pathology at the bed-side. 

Dr. F, S, Cooper, of Peoria, Illinois. — On Orthopaedic Surgery. 

Dr. Andrew F. Jeeler, of Palmyra, Mo. — On the modus operandi of the Envenomed 
Secretion of Healthy Animals, 

Dr. Samuel M, Smith, of Columbus, Ohio.-^-On Insanity. 

Dr. Rene LaRoche, of Philadelphia,— -Un the Jaundice, Yellow Fever in its diognos- 
tical and prognostical relations, 

Dr, Charles Quarles Chandler, of Rocheport, Mo.— On Malignant Periodic Fevers. 

Dr, S. B. Chase, of Portland, Maine, — On Typhoid Fever in Maine, 

Committee on Plans of Organization for State and County Societies. — A. B. Palmer, 
M. D, Michigan: R. R^ Mcllvaine, M. D, Ohio: D. L. McGugin, M. D., Iowa; E. R. 
Peasley, M. D., New Hampshire ; Thomas Lipscomb, M. D., Tennessee. 

Committee on Medical Literature. Robert J. Breckenridge, M. D.. Kentucky; O. M. 
Langdon, M. D., Ohio ; A. A. Gould, M. D., Massachusetts; D. L. McGugin, M. D., 
Iowa; J. B. Flint, M. D., Kentucky. 

Committee on Medical Education, — Wm. A. Anderson, M". D., Alabama; A. Lopez, 
M. D , Alabama; Andrew Murray, M, D., Michigan ; F. A. Ramsey, M. D., Tennes- 
see ; R. D. Ross, M D., Cherokee Nation, 

Committee on Prize Essays. — R. La Roche, M. D., Pennsylvania ; Isaac Hays M.D., 
Pennsylvania ; Alfred Stille, M. D., Pennsylvania ; J. B. Biddle, M. D., Pennsylvania ; 
George W. Norris, M. D., Pennsylvania ; Joseph Carson, M. D,, Pensylvania ; Joseph 
Leidy, M, D„ Pennsylvania, 

Committee of Arrangements, — Isaac Hays, M, D-, Pennsylvania ; G. Emerson, M.D., 
Pennsylvania; Wilson Jewel, M. D,, Pennsylvania ; Alfred Stille, M, D. Pennsylva- 
nia ; J, B, Biddle, M, D., Pennsylvania ; Francis West. M, D,, Pennsylvania; William 
V. Keating, M. D., Pennsylvania. 

Committee on Publication. — Pliny Earle, M. D,, New York ; D. Francis Condie, M. 
D., Pennsylvania ; E, S, Lemoine, M, D.. Missouri ; Francis West, M. D., Pennsylva- 
nia ; Alden March, M. D., New York ; E, H. Davis, M, D„ New York; C. Pv,. Oilman, 
M. D, New York. 

Dr. Reyburn, of St. Louis, moved that the report be adopted, with the exception of 
that portion which refers to the Committee of Publication. He remarked, in support 
of the resolution, that he saw no reason why the publication of the proceedings of the 



296 American Medical Association. [June, 

Association should he changed irom Philadelphia to New York, as was evidently in- 
tended by placing the Philadelphia portion of the Committe in the minority. He did 
not think the business would be any better done in New York, and as long as the old 
Committee performed their duty well, he did not see the necessity of the change. 

A lengthy and warm debate arose upon the resolution of Dr. Reyburn. Drs. Sayre, 
of New York; Eve, of Tennessee; Paddock, of Illinois; Herriok, of Illinois; McPhee- 
ters, of St. Louis, and Davis, of Chicago, opposed the resolution, and Drs. Storer, of 
Boston, Reyburn, of Mo., and Atlee, of Pennsylvania, supported the resolution. 

On motion of Dr. Sayre, the Association resolved itself into a Committee of the 
whole, for the purpose of considering said report of the Standing Committee. 

Dr. Elbert, of Iowa, was made chairman, and the discussion was renewed with 
^greater ardor. 

On rising, the Committee of the whole, through the chairman, reported in favor of 
Dr. Reyburn's resolution, and on motion of Dr. Atlee, the recommendation of the Com- 
mittee of the whole was adopted. 

The Association adjourned to meet at three o'clock. 

AFTERNOON SESSION — May 4, 

The Convention met at 3 o'clock. Dr. N. S. Davis,one of the Vice-Presidents in the 
chair. 

Dr. Atlee, ofPennsylvania, moved, that this Association earnestly recommend to 
their medical brethren, in the states in which Societies do not exist, the immediate or. 
ganization of State and County Societies. Adopted. 

The following resolution of Dr. Ramsay, of Tennessee, was, on motion of Dr. Coons, 
of: St. Louis, laid on the table. 

Resolued, That while this Association reserves to itself the right of expressing 
through reports of Committees, or by resolutions, its appreciation of professional quali- 
fications, or of medical education; it is iar from assuming the position of guardian of 
Medical Schools. 

Dr. Breckenridge, of Kentucky, read a resolution of Dr, Lindsley, of Tennessee 
which being amended by Dr. Smith, of Columbus, Ohio, was adopted as follows: 

Resolved, That hereafter, every paper received by this Association and ordered to 
be published, and all plates, or otuer means of illustration, shall be considered the ex- 
clusive property of this Association, and shall be published and sold for the exclusive 
benefit Of the At-sociation. 

Dr. Byford, of Indiana, offered a resolution to change the names of Committees on 
Epidemics, so as to read " Committees on prevailing diseases," Ordered to lie over 
to the next meeting. Dr, Gross, of Kentucky, obtained leave to inform the Conven- 
tion that the second volume of the late Prof. Drake was in press at Philadelphia, and 
would be issued the present summer. 

The second volume is on Practical Medicine, and is entirely independent of the 
first. 

Dr. Phelps of New York, now claimed the privilege which had been granted in the 
morning session to read the following abstract of a paper. 

" The document I hold in my hand purports to be an abstract of a paper which 
traces the connexion existing between medicine and religion in its origin and pro- 
gress, and might receive the following style, to wit: 

"Religion an Element in Medicine, or the duties and obligations of the profession." 

It naturally' divides itself into parts: the former is mainly pictorial, the latter sug- 
gestive and practical. The general scope and bearing oi the subject may be embraced 
under the following heads, viz ; 

The substance and general outline may be stated in the fallowing propositions: 

I. A recognition of the complex nature of man, his immortality, free-agency, natural 
religious propensities, and susceptibility oi indefinite intellectual improvement. 



1854.] ' American Medical Association. 297 

2. That medicine, or the art of healing, as an art, must have been of very ancient 
origin, probably coeval with, or shortly subsequent to, the Fail of Man ; but, as a sci- 
ence, of much later date. 

3. That the earliest authentic record of medicine and the profession, and the 
collateral art of the apothecary, is to be found in the Bible, and localized in Egypt, the 
great depository of learning and art in that early age. 

4. That among the Israelites under the Theocracy, and down to the time of the 
Apostles, medicine and the profession, were more or less ideniified with, or under tne 
direction of, patriarchs, prophets, priests and evangelists, or other prominent and good 
men. 

5. That the Greeks, though idolaters, were nevertheless deeply imbued with a sense 
of the claims and sacred obligations of their religious rights, and that Hippocrates and 
his disciples, as evidenced in the celebrated oath bearing his name, avouched the high- 
est religious sanctions in entering upon the responsible duties of the protession of me- 
dicine. 

6. That through the long night of the dark ages, the convulsions, the vice and down-, 
fall of nations, science, medicine, and religion feel the shock — languish and struggle 
for an uncertain existence, but are not destroyed : and with the dawning of therefor- 
mation and the consequent revival of learning, and the spirit of free inquiry, the arts, 
science and medicine as well as religion, receiving new impulses extend their do- 
mains, freedom of thought develope, new elements of improvement, and the common- 
wealth of letters measurably disenthralled, gives lustre and momentum to knowledge, 
and high promise of success to succeeding generations. 

7. The art of printing — the discovery of a new continent — of the circulation of the 
blood, and the publishing to the world the great principles of the Newtonian philoso- 
phy, together with the more general diffusion of the doctrines of the Reformation, gave 
new and increased energy and extension to thought, science, medicine, and the arts 
of civilized life, during the period included between the last half of the fifteenth and 
near the close of the seventeenth century. 

S. That still another and brighter era dawns upon the world in the last half of the 
eighteenth century, in ascertaining the identity of the electric fluid and lightning— the 
discovery of galvanism, of carbonic at id gas, oxygen gas, and the consequent devel- 
opment of the broad field of pneumatic chemistry, end pari passu with these, the in- 
creased diffusion of Christian principles and benevolence as exhibited in the Bible, and. 
other kindred Societies — hospitals, almshouses, asylums, and other numerous charit- 
able institutions — very much of the efficiency of which depends upon the science, the 
time, the sacrifice and exposure of the medical profession. 

9. That the scientific, and other general developments of the last fifty years have 
been rapid above all human conception; every department and enterprise feels the 
mighty impulse, nor an ocean or continent escapes the scrutiny of the age. The long 
standing problem proposed by Columbus, of a Northwest passage is solved. Air, steam, 
and electricity yield subserviency to the will of man and execute his pleasure. Time 
and space are measurably annihilated. Remote parts of the country are brought into 
neighborhood. Intercommunication, hitherto so difficult between distant nations, is 
facilitated ; the benign principles of the Gospel wend their way; and hence the indi- 
cation of the early universal diffusion of light and knowledge, and the final mental 
emancipation of our race. 

10. That in elaborating the world's destiny Religion is the great and all pervading 
element, and that even now it exerts a controlling or modifying influence, command- 
ing the homage and respect, either directly or indirectly, of all classes and professions. 

11. That this influence is felt and receives the sanction and ackowledgment not 
only of the profession, as evidenced in our code of ethics, but specially also as wit- 
nessed in 1 ctures, professors and presidents in their addresses, and other official acts 
in our colleges and schools of medicine. 

12. That this moral influence as a necessary sequence in professional intercourse 
with the people and with each other, is exerted on man, complex in his nature, con- 
sisting of soul and body, and these reciprocal in their action and influence, and con- 
tingent in results here and hereafter, more or less upon professional intervention in 
the treatment of disease. 

13. That hence we deduce inferentially, the solemn and responsible professional re- 
lation existing between the physician and his patients, and that in consonance both 
with the requirements of our code of ethics and the judgment of those high and honor- 
ed in the professional is obligatory on the practitioner in grave disease, seasonably. 



298 American Medical Association. [June, 

to take the initiatory demanded either for business arrangements, or leading to that 
consolation which religion can atibrd; 

14. That the prudent and discreet inculcation of the truths of the Gospel and the 
method of man's redemption by a mediator, instead of exerting an injurious effect 
upon bodily disease have often quite a contrary tendency, arresting the attention of 
the patient — leading to a different train of thought, and thus sensibly relieving anguish 
of mind and pain of body — begetting trust, confidence and joy, and often ending in 
fatal cases in a peaceful and triumphant death. 

15. That from the general scope of the subject, the compound nature of man, his 
eternity, accountability, religious propensities, intellectual susceptibility and the recip- 
rocal action of body and mind in health and disease, the doctrine is educed of the par- 
amount duty of the profession to their patients not only as regards the body in disease, 
but also the higher interests of the immortal spirit. And hence, also the just claim of 
Religion, the great anaesthetic of the immortal mind, to be considered an element in 
medicine or the healing art. 

The foregoing propositions are enforced by such considerations and reflections as 
are suggested in support of the general subject. JAMES L. PHELPS, 

City of New York. 

A motion to lay on the table was lost. 

Dr. Atlee then moved that it be referred to a special committee. Adopted, and the 
chair appointed Drs. Atlee, Sayre, and March of Albany. 

On motion of Dr. Smith of New Jersey, the regular order of business was resumed. 

Dr. Eve moved that the matter relating to the report of the Committee on Nomina- 
tions, and the blank occasioned by the amendment of Di. Reyburn, which was adopt- 
ed in the Committee of the Whole, be referred back to the Nominating Committee for 
the purpose of filling up the blank. Lost. 

The question then recurred to the original report of the Committee. Several amend- 
ments were offered and lost. 

A warm and animated discussion grew out of this question, which was participated 
in by Drs Breckenridge, Atlee, Storer, Sayre. McDowell, of St. Louis, White of Buffalo, 
and sev* ral others,which resulted in the adoption of the original report of the Commit- 
tee on Nominations. 

On motion of Dr. White, of New York, it was unanimously 

Resolved, That a vote of thanks be returned to the late Publishing Committee for 
their best endeavors to serve the Association. 

The following communication was then read— 

The delegates from Philadeldhia feel themselves authorized to resign, in the name 
of Dr. Condie of Philadelphia, the office of Treasurer of the Association. 

(Signed) RENE LA ROCHE, on behalf of the Philadelphia delegation 

The resignation of Dr. Condie was accepted, and on motion Dr. Charles Hooker of 
Connecticut, was elected Treasurer. 

Dr. Hooker declined, and his resignation was accepted. 

Dr. F. West of Philadelphia, tendered his resignation as Secretary. It was refused. 

A resolution was unanimously adopted, tendering the thanks of the Association to 
to Dr. Condie for the able a,nd thorough manner in which he had performed the ardu- 
ous duties as Treasurer. 

On motion of Dr. Breckenridge of Kentucky, it was 

Resolved, That hereafter, the majority of the Committee on Publications shall be se- 
lected from among the Physicians of that city in which the Association may annually 
meet. 

A motion to amend the Constitution, providing that the Association meet on the se- 
cond instead of the first Tuesday of May, was laid on the table for one year. 

A resolution of thanks was unanimously tendered Dr. Ninian Pinckney, for the able 
address delivered by him before the Association. 

Dr. J. K. Bartlett of Wisconsin,, moved, and it Was unanimously adopted that th$ 



1854.] American Medical Association. 299 

thanks of the Association be tendered the Committee of Arrangements, the Physicians 
of St. Louis, and the citizens for their kind hospitalities, which they have extended to 
its members during their session in this city. 

The thanks of the Association were also voted to the several Steamboat and Rail- 
road Companies that had so generously offered a free passage to members returning 
from the Convention. 

Dr. W. W. Hitt of Indiana, offered the following — 

Resolved, That a Committee of members be appointed to examine into and re- 
port upon the effects of Alcoholic Liquors upon the human system in health and disease. 

Adopted and referred to the Nominating Committee. 

Dr. Blatchford was nominated as Treasurer, by Dr. White in behalf of the Nominat- 
ing Committee. Dr. Blatchford declined serving, and subsequently the Committee re- 
ported the name of Dr. Isaac Wood of New York. They also reported the name of 
Dr. William D. Haskins of Richmond Virginia, as chairman of the Committee on Epi- 
demics of Virginia and North Carolina, instead of Dr. Peebles resigned; 

The resolution of Dr, Hitt in reference to alcoholic drinks was reported back by the 
Nominating Committee, referring it to a special Committee consisting of Dr. Mussey, 

A letter from Dr. Englemann of St. Louis was read requesting to be discharged from 
the committee on the influence of Geological formation on the character of disease. 
His request was not granted. 

Dr. J. B. Lindsley offered the following resolution. 

Resolved, That the too prevalent practice of Professors in Medical Colleges recom- 
mending their own writings and editings as text books for their students, is in the 
opinion of the Association a serious evil tramelling as it does, the student in his 
choice of books, and promoting the publication and circulation of works of inferior 
merit. 

On motion it was laid on the table. 

A vote of thanks was returned to Dr. Hooker, Treasurer, pro tern. 

On motion the Convention adjourned sine die. 

The President, Dr. Pope, wished the members all a safe return to their families and 
friends, and expressed the earnest desire that they would all meet again at Philadel- 
phia, next year. He then declared the Association adjourned. 



THE 

NEW JEESEY MEDICAL EEPOETEE. 

VOL. VII. J U L Y, 1 8 5 4 . NO. VII. 

Cynanche Trachealis. By William Johnson, Mi D. 

[ READ BEFORE THE DIST. MED. SOCIETY OF HUNTERDON CO. ] 

Gentlemen : 

Agreeably to a resolution of our last meeting, that each member read 
a case of disease, treated by him within the past six months, I present 
the following case of croup. 

I was requested; in the morning of the 28th of last February, to Visit 
a child of A. H., aged 19 months, with Croup. I learned upon inquiry 
that the child had been sick about 36 hours, having contracted a cold 
from being taken by his parents, on a visit about nine miles off. I found 
him with fever — -great degree of dyspnsea — : head thrown back in respi- 
ration, so as to enlarge the capacity of the chest- — cough brassy, and 
characteristic of croup — surface of the body preternaturally warm. A 
careful examination of the internal posterior fauces could detect nothing 
abnormal — no inflammation — no diphtheritic deposit. 

I prescribed hyd. chlor. mit. et ipecac, aa gr, v pro dos. and left him two 
other powders of ipecac, each containing 5 grs., to be repeated every 
half hour, until free emesis took place. The patient was visited by my 
son in the evening, and found somewhat relieved — breathing less diffi- 
cult. He left him 20 grs. more of the ipecac, to be given so as to keep 
up a nauseating impression. 

March 1st. Saw the child in the morning — found much less im- 
provement than I had hoped for — respiration exceedingly embarrassed — 
bronchial secretions locked up — the stridulous cough continues — much 
fever — skin hot. I left him 15 grs. of calomel in seven powders- — one 
to be taken every two hours, unless the effects upon the bowels should 
be too great. 

In the evening there was considerable improvement. The powders 

had not operated with any violence. Continue. 

2d. Saw the patient in the morning — found him very greatly irn- 
39 

/ 



302 Original Communications. [July, 

proved — was playing about upon the carpet — countenance animated — 
secretions of the mucous membrane, both of the trachea and nares, re- 
stored, but there was still some degree of embarrassment in the respira- 
tory function. Gave 5 grs. more of calomel in 3 doses — a dose to be 
taken every four hours, and between each dose of the calomel one six- 
teenth of a grain of tartarized antimony : to have the feet immersed in 
warm water. The child was not so well in the evening — the tartarized 
antimony had produced too much depression by its action on the bowels, 
and had not acted on the secretions : it was discontinued. Directed the 
repetition of the pediluvium. 

3d. Morning. Found the child not so well as yesterday morning : to 
repeat the pediluvium : left 5 grs. more of calomel, to be given in three 
doses as before directed. The medicine did not act inordinately on the 
bowels. Between each dose of the calomel the child was directed to 
take 3 grs. of bicarbonate of potassa. 

In the evening, the respiration still remaining embarrassed, I gave the 
child 3 grs. of assafoetida, in the form of lac assafcetidse, every two hours. 
The secretions had again become locked up, and the cough stridulous. 
There was fever, and hot and dry skin. Repeat pediluvium. 

4th. Found the patient very much improved — had taken the medi- 
cine regularly — the secretions from the nares restored, and cough loose. 
The assafoetida had agreed so well, that I directed nothing more than it 
and the bicarbonate of potassa — the assafoetida to be given every two hours, 
and with every alternate dose, the bicarbonate. 

5th. Improvement still continues — made the intervals of giving me- 
dicine every three hours, instead of every two hours. Continue assafoe- 
tida and bicarbonate of potassa. 

6th. Improvement still continues. Continue treatment as directed 
yesterday. 

The next day I concluded to discontinue my visits. The child rapid- 
ly recovered. 

Remarks. — The foregoing case is one of the ordinary form of croup : 
cynanche trachealis, originating from exposure to cold. There was no 
doubt of inflammatory action kindled up in the lining, tracheal, mu- 
cous membrane. It is a disease in which I have seen more decided, un- 
equivocal benefit from tartar emetic and calomel, than from any other 
articles of the materia medica. I have ever made these articles the sheet 
anchor of dependence. In the early part of my practice, when I used 
the tartarized antimony more freely than I do at present, my success 
was certainly greater in the management of this disease. Tartar emetic 



1854.] Johnson — Cynanche Trachealis. 303 

tells on croup ; it produces a salutary systemic impression ; it equalizes 
excitement; it relaxes spasm; it ejects irritating material from the tra- 
chea; it subverts inflammatory action, and thus prevents the formation 
of false membrane ; it controls the circulation ; it restores perspiration. 
It is admissible at any period prior to the formation of the false mem- 
brane, unless there be too much flagging of the vires vitas ; then ipecac 
is the preferable article. After the formation of false membrane, the 
great object is to eject it by the mechanical agency of vomiting, 
and here ipecac, sulph. zinci., sulph. cupri, are the preferable articles. 

The remark is trite, that there is fashion in medicine, as well as in 
every thing else. Much has been said of the poisonous effects of tartar 
emetic in its administration to children. Such effects, I have never 
myself witnessed in a single instance. It is true that I have seen very 
great prostration — sometimes rather alarming, produced by it, but the 
patients have speedily rallied. Still, I will not discredit the statements 
which have been made on this subject by others. It is my belief in 
these statements that has rendered me more timid in the use of the 
article. 

I always follow up the use of the tartar emetic by calomel, and gene- 
rally find the patients benefitted, where the stools assume a dark green 
hue, resembling chopped spinach. In the case just related, the child took 
5 grs. of calomel and 5 grains of ipecacuanha as an emetic, but I am 
inclined to think, that if the tartar, instead of the ipecac had been em- 
ployed, the remedial effect would have been more satisfactory. I com- 
menced with the calomel, as I have before remarked, on the 2d day of 
the disease, in doses of two grains every two hours, and continued it to 
the 4th day inclusive, but at longer intervals. The child took, in the 
whole, 30. grs. of calomel : its action on the bowels was not excessive, 
and the patient for the first two days, greatly improved under its use. 
My only reason for discontinuing it, was the dread of its action on the 
mouth — a circumstance greatly to be deprecated, as almost certain to re- 
sult in the death of the child. Such an event I know has taken place 
several times in the practice of my neighbors, and it has made me cau- 
tious. It is true, that, I well know, that the constitutions of children 
are not as susceptible to mercurial impression as those of adults, and 
that Dr. Stearns, of Albany, who was very successful in the treatment 
of croup, was in the habit of giving 30 grs. of calomel and 2 grs. of tar- 
tar emetic at a dose to children under two years of age, and even repeat- 
ing it twice, and that Dr. Hamilton, of Edinburgh, administered calo- 
mel to the extent of one hundred grains in twenty-four hours, to very 



304 Original Communications. [July, 

young children. Yet I also know, that very young children, when mer- 
curialized, are liable to destructive caries of the jaw. I believe that the 
child would have recovered under the use of the calomel, (and I am war- 
ranted in this conclusion by the benefit actually derived from its use,) had 
not the parents suffered him to run about the room, which was not suf- 
ficiently warmed. I thought it best, however, to discontinue it, and 
look out for some other remedial agent. This I found in the lac assa- 
foetidae, and under the use of this article, and the bicarbonate of potassa, 
he speedily recovered. 

In the close of this case, permit me to say a few words on the use of 
assafoetida in croup, and the therapeutic relation of this article to the 
disease. I was led to the use of this article about 40 years since, in the 
treatment of a case of croup, which had been protracted five days in de- 
spite of tartar emetic, calomel, and the lancet. I began to look upon 
the case as hopeless, when I determined to try the assafoetida, but the 
child resisted so lustily the taking of it by the mouth, that I was com- 
pelled to give it as an enema ; and whilst the child was held by the mo- 
ther, I threw up 20 grs. of assafoetida, in solution, into the rectum. The 
effect was magical — the difficulty of respiration was vastly relieved, and 
in two hours I repeated the enema. The dyspnoea — the convulsive re- 
spiration was in a very short time entirely gone, and so complete was 
the relief, that in looking back to the case of which I took a note at the 
time, I do not find that I prescribed another dose of medicine for it. 
The child was three years of age, and took 40 grs. of the assafoetida by 
enema. The recovery was complete, and the patient is living at this 
time. I have often prescribed the assafoetida since, in a disease in some 
of its features resembling croup, namely, pseudo tracheitis — the asthma 
thymicum of the German pathologists, but never with such striking ef- 
fects as it here displayed ; a disease which had run on full five da}^s, 
was cured in little over two hours. This disease was genuine croup, if 
brassy cough, pyrexia, and most distressing dyspnoea are characteristic 
of it. 

The foregoing two cases are the only ones of what I considered to be 
genuine croup, in which I have employed the assafoetida. My patholo- 
gical views of the disease have deterred me from the use of the article. 
These cases, as I have stated already, I began to look upon as nearly 
hopeless, when I commenced with the assafoetida. 

I should never think, notwithstanding the happy results obtained 
from the assafoetida in the foregoing cases, of prescribing the article at 
the commencement of genuine croup. In both of the cases which I * 



1854.] Johnson — Cynanche Truchealis. 305 

have related, the heat of the surface was somewhat abated before resort- 
ing to the assafcetida. This diminished temperature was perhaps more 
owing to impaired vitality, than to any subduction of disease ; and in 
the case first related, the tracheal secretion had been partially restored 
by previous medication, before resorting to the assafoetida, although they 
had again become locked up. 

There is, however, a species of croup — pseudo-tracheitis — in which 
we may very early resort to the assafoetida, with prospect of great suc- 
cess — in fact, immediately after the exhibition of an emetic. 

This disease presents itself to us under a variety of features; the 
peculiar spasmodic affection of the thumbs and toes, is sometimes ab- 
sent. In one of its forms, and that not a very unfrequent one, it ap- 
pears in its pathological relations, almost as nearly allied to asthma as 
to croup, but unlike asthma, the respiration is hurried. It resembles 
genuine croup in almost every thing except the brassy cough. Its in- 
vasion, like genuine croup, is somewhat sudden ; the child has com- 
plained a day or two of cold. The respiration is loud and hurried; the 
dyspnoea threatening immediate suffocation ; the nostrils expanded ; con- 
siderable fever and beat of surface; but immediately you hear the 
cough you are satisfied that it is not genuine croup. The cough is hu- 
mid ; it is a pseudo-disease. This disease is often confounded by care- 
less practitioners, with genuine croup. 

In all the forms of pseudo-tracheitis the assafoetida displays most sig- 
nal powers, and it is in these forms of disease that I prescribe the arti- 
cle with much confidence of benefitting my patients. If the patient be 
not much benefitted by the first six or eight doses of the assafcetida, I 
do not urge its further use. 

As I was not present at your late meeting, when cynanche trachealu 
was the subject of colloquial discussion, indulge me in a more extended 
view of my practice in this disease. I have said nothing yet on the use 
of the lancet in this affection, and it is because I do not lay much stress 
upon it. I have but seldom resorted to it. My principal reason lias 
been a conviction, that inflammation of the mucous membranes, is not 
benefitted like inflammation of the serous membranes and other tissues 
of the body, by this potent remedy. I have never used the lancet in 
cynanche trachealu upon any subject under three years of age. I have, 
however, taken notes of a case of more advanced age, where venesection 
did display most unequivocal powers, and as the case possesses some in- 
terest, I shall relate it. 

Oct 6, 1814. — I. B., a rustic youth, aged 13 years, having contract- 



306 Original Communications. [July, 

ed a catarrh, and feeling that febrile lassitude which so frequently at- 
tends it, imprudently lay upon the ground, yet damp with the rain of 
the preceding day. He was in a short time seized with as severe an 
attack of croup as I have ever witnessed, threatening almost immediate 
suffocation, and attended with great flushing of the face, and respiration 
so laborious and difficult, as to be heard out of the room. I bled him 
immediately, 10 or 12 ounces — gave 6grs. of tartar emetic in divided 
doses, and immersed his feet in warm water, in which he kept them 
until after the operation of the emetic. Great relief was afforded by the 
bleeding and emetic, but still the breathing continued difficult and op- 
pressed, and the cough dry and stridulous. In one hour after the emet- 
ic, I ordered him to take 15 grs. of calomel, and to take freely of warm 
diluent drinks. 

I called to see my patient again in two or three hours, and finding 
that the disease was not yet subdued, I left him 6 grs. of tartar emetic, 
with 15 grs. more of calomel, to be mixed up in 6 tea spoonsful of mo- 
lasses, with directions to take one tea spoonful every hour, until it 
operated as an emetic or cathartic, and then every two hours after. He 
took four spoonsful, which evacuated him powerfully. The next morn- 
ing I found that the disease was completely strangled, expectoration 
free, and fever and inflammation removed. 

Time admonishes me to be brief in my comments on this case. The lad 
was certainly benefitted by the venesection which I employed ; it reliev- 
ed very much the oppression under which he was laboring, but how far 
it went towards the cure I am not prepared to say. Powerful auxiliary 
medication was simultaneously employed. He took 10 grs. of tartar 
emetic, and nearly 27 grs. of calomel, and all in the space of a few 
hours. 

With respect to bleeding in croup, indulge me in a few additional re- 
marks. I have stated my practice, and given the reasons which have 
influenced it. I am willing to compare notes with those who confide in 
this remedy in the treatment of croup. I believe that my practice, if 
not more successful than theirs, is at the least as much so. I intend to 
bring forward but a single name in favor of the lancet, in croup. It is 
that of Dr. Watson, than whom, a greater name has never adorned our 
profession. I shall quote his own language. " Croup is a disorder 
which may justly excite extreme alarm in the friends and parents, of the 
patient ; for the prognosis can never be better than doubtful. It is said 
that four children out of five attacked by it used to die, but that now 



1854.] Williams — Imaginary Diseases. - '307 

the treatment being better understood than formerly, the number of 
deaths, and the number of recoveries are nearly equal." 

Dr. Watson's practice, both hospital and private, was very great. The 
lancet was his sheet anchor of hope, and he has given the results. I 
seldom use the lancet in croup, and I honestly believe that I do not 
lose one in fifteen of all the cases treated by me. 

In a disease very nearly allied to croup, I mean laryngitis, the lancet 
is almost the only remedy entitled to confidence. But its subjects are 
adults,and can best bear these drafts of vitality. 

The nitras argenti is another remedy which I have not very frequent- 
ly used, but where there has been inflammation of the fauces, or diphthe- 
ritic deposite, I have certainly seen most unequivocal proofs of its effi- 
ciency. The fauces have been sponged with a strong solution of the 
article in water. Where the foregoing conditions have not obtained in 
croup, I have not used the article. 

I have sometimes used the warm bath in this disease, with marked 
and most unmistakable benefit to my patients. But, if not resorted to 
until the vires vitae begin to flag, I consider it a doubtful, if not a haz- 
ardous remedy. I should not recommend it in this state of the system. 
There are also some objections to the use of this remedy, from the 
struggles which it produces on the part of the patients. The objections 
which may be urged against the warm bath, apply in a minor degree to 
the pediluvium. 

I have very seldom seen good from the application of blisters in croup* 

White House, May, 1854. 



Imaginary Diseases. — By Stephen W. Williams, M. D., &c. &c. 

[ LATE OF DEERFIELD, MASSACHUSETTS.] 

Some of the most distressing complaints to which humanity is liable, 
are diseases of the imagination. They are a species of monomaniac insan- 
ity, frequently beyond the reach of medicine, and often beyond the acutest 
reasoning of the physician and the divine. They not unfrequently lead 
to the most depressing melancholy, to despair, and even to suicide. They 
also often lead to actual disease, particularly of the chylopoietic viscera. 
Imaginary hallucinations, however, sometimes lead to pleasurable sensa-? 
tions, as in the case of the man who fancied himself to be the Lord and 
Saviour of the world, who was tried before Lord Erskine. This phan- 
tom of the imagination must only be productive of pleasurable sensa- 
tions, during its continuance. How many men have fancied themselves 



308 ' Original Communications. [JtrLJr, 

to be Presidents, Kings, and Emperors, Generals, and Commanders 
of armies, and have led their soldiers on to victory. But I will proceed 
to the relation of a few cases, which have fallen under my observation. 

A patient called upon me a few years ago, who fancied that he had 
the venereal disease from cohabitation with a cow — he was a simple fel- 
low, and was much alarmed about himself. The complaint had been 
upon him four or five years, or he fancied that it had. He called upon 
a noted empiric in a neighboring city. He saw him but a few minutes, 
and gave him some medicine, for which he charged him fifty dollars. 
He paid him nine dollars, all the money he had with him, and for more 
than three years he continually dunned him for the remainder, till he 
paid no attention to his letters, although he threatened to sue him. I 
had another patient in the same region, whom he treated in a like 
manner. I ascertained to my own satisfaction that the only actual dis- 
ease he had upon him was occasioned by masturbation, though he fan- 
cied that he still labored under the venereal disease* I assured him 
that he was cured, but I never could make him believe it, and I was 
obliged to give him some little placebo or nostrum, to satisfy his mind. 
He called upon me once in about three months, for the space of five or 
six years. He died some time in the course of the year 1853, but, as 
he lived some distance from me, I did not see him in his last sickness, 
and do not know of what complaint he died, though, I believe, it was 
pneumonia. So far as my observation goes, the venereal disease has 
never been known to prevail among animals. 

Shortly afterwards, I had another patient who fancied that she took 
the venereal disease twenty-two years ago, from washing the linen or 
making the beds of two young men, who she imagined had that com- 
plaint. It was never known that they had the disease ; on the contrary, 
it was almost certain that they never had it. She never knew any thing 
about the venereal disease until six years afterwards, when she accident- 
ally heard some old woman talk about that complaint, and afterwards 
she fancied that she took it six years before, in the manner described. 
The delusion lasted but a short time, and she married soon afterwards and 
had three children. The two youngest died either in the birth or soon af- 
ter. Just before the birth of the last child, she fancied that she had the 
same complaint, but she said nothing to me about it. Her child died 
when two or three days old, and she mourned herself almost into a state 
of derangement, in consequence of it. She fell under the care of ano- 
ther physician, who, for a biliary derangement salivated her severely. 
She was then about 40 years of age. Some time afterwards she fancied 1 



1854.] Williams — Imaginary Diseases. 809 

that she was pregnant again, when, in fact, the irregularities of her 
menstrual flux were owing to the critical period of her life. Her old 
vagaries returned upon her, and she firmly believed that she had the 
venereal disease from the same cause. I could not reason her out of it, 
and as she had fretted herself into sickness, she persuaded me to put 
her upon a course of mercury, which I told her would probably cure her, 
as it was almost or quite, a specific. My principal object was to induce 
a new disease upon her, and turn her attention from the subject of her 
delusions. I also believed it would be of service to her on account of 
her biliary affections. I salivated her, and I thought 1 should hear no 
more about her old complaints. But they soon returned upon her im- 
agination with violence. I knew that her delusions were in consequence 
of mental derangement, as her grandfather, mother, and sister had pre- 
viously been afflicted with mania. She Was willing to go to the Insane 
Hospital, and her husband soon after carried her there. She was bene- 
fitted for a while, by her residence there, but soon after her return home 
she relapsed again, and again went to the hospital, and again regained 
her health, both mentally and bodily. She has now been with her fami- 
ly several years, without any return of her complaints. 

A short time ago, I was called in haste to a young man not far from 
22 years of age, who had partially castrated himself by removing one of 
his testicles with a razor. His intention was to remove both of them, 
but he bled so profusely that he was deterred by it. He lost an enor- 
mous quantity of blood, and I was obliged to tie the spermatic arteries 
as soon as possible, which I found very difficult to do, on account of the 
retraction of the cord. He had been troubled for more than a year with 
involuntary seminal emissions, which weakened him very much. He 
had a fever a little more than a year before, which left him quite debili- 
tated, and he had not entirely recovered from it. He was told by one 
of his confidential companions, that he could never be cured of the com- 
plaint in any other way than by castration. He was also told of a 
young man in a neighboring town, who was afflicted in the same way, 
and that he performed the operation of castration upon himself, and was 
cured by it. This was the cause of this young man's resorting to this 
fool-hardy and dangerous act. 

In the Boston Medical and Surgical Journal for 1842, 1 believe, there 
is an account of the operation of castration being recommended and per- 
formed by a Doctor, upon a young man, for this complaint, which cured 
him, and so would cutting off his head have cured him. The Doctor 

was most severely criticised, and justly castigated soon after, by two em- 
40 



310 Original Communications. [July, 

inent physicians, who exposed his folly, if not his wickedness in this 
operation, and I think he will not resort to it again. 

About the time that I commenced the practice of my profession, a 
man in a neighboring town emasculated himself with a dull case-knife, 
for alleged unfaithfulness with his wife. He cut off both testicles and 
the penis, and finally recovered. I have seen frequent accounts of self 
castration, but the wonder is in such cases, how hemorrhage can be arrest- 
ed without tying the arteries of the cord. 

Laona, Winnebago Co., III., May 25, 1854. 



Placenta Prcevia.^—~BY 0. H. Taylor, M. D. 

In examining the recent Medical Report from Gloucester County, N. J., 
I observe that Dr. Sickler has presented, with some interesting remarks, 
two cases of presentation of the placenta, in each of which, the placenta 
was spontaneously delivered before the birth of the child. 

The question, whether the result so happily effected by nature, in 
these instances, should ever be promoted by art, is one that has been 
canvassed of late, by obstetricians, with deep interest and anxiety. Nor 
is this surprising, when we consider the extreme urgency of the dan- 
gers threatening the mother from hemorrhage, and the vital importance 
of the function of the placenta, even during labor, if at all protracted. 

From my own observation and reflection on several cases of attach- 
ment of the after-birth over the os uteri, coupled with severe hemor- 
rhage, which have occurred in my practice, within the last twenty-eight 
years, I am induced to coincide with Dr. Sickler in opinion, not only 
as to the propriety and safety, but the absolute necessity, in certain cir- 
cumstances, of removing the placenta before the delivery of the child. 
,That the established method of turning the infant in cases of severe he- 
morrhage, during parturition, may be impracticable, without great delay, 
when the os uteri is but slightly dilated, and presents rigid and unyield- 
ing edges, every experienced practitioner is aware. The strength of the 
mother may be fatally exhausted before the hand can be introduced. 
Even in the most favorable cases, the condition of the placenta during 
the delivery, with much of its surface still adherent, and preventing the 
contraction of the bleeding vessels beneath the detached portions, is in- 
calculably more favorable for an arrest of hemorrhage, than if it were 
entirely detached ; and the question of danger to the child, from the re- 
moval of its external lungs before its mouth reaches the atmosphere, is 



1854.] Taylor — Placenta Prcevia. 311 

one of time only. If there be a possibility of a rapid delivery, we should 
not hastily allow this danger to prevent us from giving the greatest pos- 
sible security to the parent. 

Three cases of placenta implanted over the os uteri, occurred to me 
in the early part of my practice, and their history proves how fatal may 
be the results of uterine hemorrhage, even during the act of turning and 
delivering the child. In each of these cases, the operation of perforating 
the after-birth, was performed in the presence, and by the counsel of the 
late distinguished Professor James, of the University of Pennsylvania, 
Dr. Charles D. Meigs, now Professor of Obstetrics in Jefferson Medical 
College, being also present in consultation, in one of these cases. All 
these cases terminated fatally in a very short time after the delivery of 
the infants, which were still-born. Neither of the mothers survived 
more than three hours, and all died from the exhaustion caused by ex- 
cessive hemorrhage. 

That the operation of removing the placenta immediately, when found 
to present itself at the os uteri, is capable of being performed with safe- 
ty to both mother and child, under favorable circumstances, I am fully 
convinced ; but as Dr. Sickler very pertinently remarks, " the advisabil- 
ity, and determination of the conditions in which it should be practiced, 
must be decided by an induction from a larger number of cases than 
have as yet been submitted to the profession." 

My own experience leads me to the conclusion, that when the placen- 
ta is fairly implanted over the os uteri, and is firmly attached through- 
out its borders, it can be removed before delivery, with more safety both 
to the mother and child, than can be secured by perforating or elevating 
the edges, and bringing the child down by the feet. 

In nearly all the cases that I have witnessed, expulsive and efficient 
pains have been brought on soon after the placenta has been completely 
detached; and these pains have continued, so as to produce the prompt 
expulsion of the child, whenever the presentation has been natural. 

Even when the cornplication is coupled with a preternatural presenta- 
tion, it does not appear to me, that the immediate delivery of the pla- 
centa is necessarily contraindicated. It would be folly to dwell upon 
the imminent danger to the child in such cases ; and if the hemorrhage 
be permitted to continue unchecked during the protracted delivery by 
the feet, (supposing this to be possible in the case) what will be the fate 
of the mother ? Should we not give her the advantage of that arrest of 
hemorrhage, which appears so generally to follow the entire detachment 
of the placenta, even before its positive expulsion ? Certainly we should, 



312 Original Communications. [July, 

at least whenever the presentation or the condition of the patient, can be 
ascertained to be such, that very prompt delivery by the feet is imprac- 
ticable; for then the death of the child is insured at all events; and as 
has been already hinted, it is precisely when such prompt delivery is 
most easily effected, that the danger to the cbild from the previous de- 
tachment is least, and the advantage to the parent, I think, indisputa- 
bly the greatest. 

I throw out these few suggestions to the profession, in the hope of 
inducing the report of every fact, which may tend to decide one of the 
most important practical questions which has been mooted by obstetri- 
cal practitioners for many years. Uterine hemorrhage has long been 
the terror of both patient and physician, and any thing which tends in 
the least degree to lessen its dangers, is worthy of the most profound 
respect and serious consideration. 

Permit me then, to offer, in concluding this note, the abstract of a re- 
cent case, in which the effect upon uterine hemorrhage produced by the 
expulsion of the placenta before the delivery of the child, is happily 
illustrated. 

On the 27th of April, 1853, I was requested to visit Mrs. B., on ac- 
count of a profuse and unnatural flow of blood from the uterus. She 
considered herself as being eight months advanced in pregnancy. At 
the time of my first visit, she was not complaining of much pain, though 
the hemorrhage was very considerable in amount. 

A digital examination proved that the os uteri was but slightly dila- 
ted. I directed pulv. acetat. plumbi et opii, but found it necessary also 
to apply the tampon, by means of which, the bleeding was restrained, 
and I was enabled to leave my patient in an hour. 

After the lapse of eight or ten days, the flooding recurred, and the 
same treatment was repeated, with a similar result. 

On the 15th of May following, being the 19th day after the first at- 
tack, I was again summoned to the case, and found the patient laboring 
under a hemorrhage quite as profuse, as at the time of the first visit, or 
even more so. By an examination per vaginam, I found the os uteri 
dilated about two inches. The placenta was evidently implanted imme- 
diately over it. By pressing the index finger firmly towards the right 
ilium, I detached a portion of the adherent placenta, and was able dis- 
tinctly to recognize the presenting portion of the foetus, which proved to 
be the head. 

Periodic pains of the regularly expulsive character were now esta- 
blished, but each was accompanied with a t n excessive discharge of bloook 



1854.] Parrish — Change of Lift in Women. 313 

The immiaency of the danger to the mother from hemorrhage, indu- 
ced me to decide that nothing would be forfeited by following any plan 
of action calculated promptly to arrest it. I therefore proceeded to sepa- 
rate the -attachments of the placenta to the uterus, in the hope that, 
possibly I might be able to thrust the after-birth back from the orifice, 
and thus enable the head to engage itself in the superior strait. On 
making the attempt to push the placenta beyond the presenting part of 
the head, however, I found myself opposed and thwarted by the descent 
of a large portion of the mass into the vagina. The result accorded with 
the experience adduced from the history of other and parallel cases; for 
two or three more pains completely expelled the placenta into the vagi- 
na, and the hemorrhage then instantly ceased. In five or six minutes 
more the child was born, and although reasonably a little languid at 
first, it soon began to cry, and has since been a healthy and promising 
child. 

Camden, May 22, 1854. 



" The Change of Life,** in Women; with remarks on the periods 

usually called " Critical." 
By Joseph Parrish, M. D. 

NUMBER V. 

The touch—Its value, compared with the value of the Speculum — Peculiari- 
ties of the first " Change." The cause of Menstruations. Puheric Age. 

The last paragraph of our last Essay upon this subject, declared the 
speculum practice, per se, to be unobjectionable, but, the speculum spe- 
cialty as adopted by many, an outrage. It is but fair, as we have ven- 
tured this rather wholesale assertion, that we should present our views 
of what may be substituted for this system of inspection. This we shaH 
do before we proceed to notice some of the diseases of the periods of 
" change;" for we are aware that the speculum has many strong advo- 
cates, and we would not be arrayed against them, or their system (for 
such we must call it), without offering a few suggestions on the Touch. 
The eye, it is true, presents its claim to superiority over the finger, how- 
ever delicate and sensitive may be the latter ; but we claim for the touch 
more perhaps, than our vision-scry friends are disposed to grant us. And 
as we press our claim, we ask an honest hearing. 

The sense of touch has been bestowed upon us, that by it, we may 
discover the palpable qualities of bodies, their size, consistence., &c. We 



314 Original Communications. [July, 

cannot tell the consistence of a body without touching it. If we would 
know of its sensitiveness, we must touch it. The mind may quail be- 
fore a glance of fire from the eye, — rthe soul, conscious of guilt, may 
tremble under the gaze of accusing innocence ; but the tangible form of 
an organized, material structure, needs to be handled, that it may be 
measured, weighed, and accurately judged of. We have to do now with 
a womb, supposed to be diseased. It is certain, says the prescriber, some- 
thing is the matter. The woman is in bad health, and as the stomach, 
and liver, and kidneys, and intestines, all seem to be well, her womb 
must be out of sorts, and hence it must be looked at. Why so? The 
liver was once diseased; there was a violent, active, inflammation, and 
did you look at the organ ? No. Did you feel it ? Yes. The stom- 
ach, not long ago, was the seat of an a^-ute gastritis. Did you look at 
that ? No. Did you feel it ? Yes. The intestines were almost eaten 
through with ulceration, and you knew the exact spot where the process 
was going on, Did you see the spot ? No. Did you feel it ? Yes. 
The uterus is now supposed to be in an abnormal condition. It is 
thought to be so, because there is a H change of life" with the patient. 
What is to be done? Is it necessary, right away to procure the specu- 
lum, and proceed to a visual examination ? Is it even necessary to pre- 
scribe the Touch ? In the majority of cases, not. You did not look 
at the stomach, and liver, and intestines, because you could not. The 
integuments that cover them were i^ot made transparent, and light would 
not deviate from the laws which govern it, and hence you did not see. 
You pressed with your finger through those integuments, and measured 
£he boundaries of the disease as well as you could ; you heard the re- 
sponses of the patient, and recognized the points of pain, and could 
judge of their particular locality. Now, you want to see the uterus, 
though it may be very readily felt, because somebody has invent- 
ed an instrument through which you may look. You have not keen so 
indelicate as to touch : you have not with your finger measured the size 
of tlie womb — nor judged of its sensitiveness; you do not know whether 
it is hard or soft, and yet you must throw candle-light upon it, to an- 
swer these questions, which an intelligent touch alone can answer. 

You know, or think you do, what can be done with the speculum. We 
know, or think we do, what can be done without it. Let us compare. 
We may pass the finger directly in contact with the os uteri, without 
disturbing its position, and judge immediately of its locality. If it is too 
J^igh, or toQ low, too much anteriorly or posteriorly, we know it. What 
can be done more with a speculum, as to position ? Indeed, tlm rota- 



1854.] Parrish — Change of Life in Women. 315 

tion of the instrument and its proper adjustment, may disturb the posi- 
tion of the organ in such manner, as materially to interfere with form- 
ing a correct diagnosis. We may touch the anterior and posterior lips, 
— press, and ask the patient if she suffers pain, and thus judge of its sen- 
sitiveness. Could the eye do more ? We may feel if it is soft or hard, 
ulcerated or congested — will the speculum answer more correctly ? We 
want to know the temperature of the organ, and surrounding parts. The 
quality in this respect, is imparted to the finger. Is it to the eye ? Im- 
mediately connected with temperature, is the question of moisture. How 
much secretion is there, and what its kind? Can the eye discern better 
than its more humble adjunct? 

The color and consistency of the secretion, it is important to recognize. 
May not this be brought to view upon the napkin, by the finger, and 
judged of more accurately than at the apex of the vagina, through a tube, 
and by an artificial light ? Then, with reference to the weight of the 
organ, which is not an unimportant item in the diagnostic to be sought. 
Will not the sentient fibrils tell as true a story as the nervus opticus f 
Who can doubt it ? But we will not be so unreasonable as to assert 
that the speculum is a useless instrument. We believe to the contra- 
ry. While by the touch we may appreciate structural changes in the 
organ — measure its bulk, and judge of its consistency, the speculum 
may be used to observe the limits of excoriation, or whatever form of 
lesion may be present. At the same time, without it, we may judge 
with tolerable accuracy, from analagous appearances in other parts of 
the body. An ulcer upon the cervix uteri, will not perhaps differ much 
from an ulcer upon the leg, and the surrounding tissues in either case, 
may be marked by similar appearances. The treatment will be founded 
upon the same principles, though there may be a difference in the mode 
of its application. We cannot therefore admit that there is a very great 
variety of cases, where this instrument, valuable as it may be sometimes, 
is really needful. Indeed, we readily conceive of some, where the use 
of it would be manifestly improper. They are these — In very young 
persons, the hymen must be lacerated, (as has often been done by skil- 
ful operators), and the injury resulting from such introduction, is, we 
venture to believe, and declare, more serious in the majority of cases, 
than the original complaint, if really any may have existed, for the dis* 
co very of which the speculum was used. In very old persons, or even 
in those of matronly age, who often think themselves the victims of 
uterine disorder after the cessation of the menses, the vagina is contract- 
ed, from a natural shrinking of the muscles. And from cicatrices of old 



316 Original Communications. [July, 

I 
injuries, or diseases, there may be tough fibrous bands stretched across 

its caliber, so as materially to interfere with the introduction of the in- 
strument. Again, in cases of irritable uterus, or irritable vagina, or se- 
vere inflammation of the parts, the diseased action, is very liable to 
be aggravated, whether it be a primary irritation, or a well developed 
phlogosis, by the distension, and suffering consequent upon its use. 
We therefore denounce the premiere resort to the speculum as unphi- 
losophical, unnecessary, and dangerous. At the same time we admit 
that as a derniere means, it may be used in many cases. The rule should 
be this. Cultivate the touch, — teach the finger to its utmost power, and 
remember that in doing this, the mind acts more acutely, and as it acts, 
becomes stronger, and more accurate in judgment. When the finger 
fails to detect the difficulty, use the speculum — use it too, of necessity, 
where local treatment is demanded ; but use it not, where it may not be 
imperatively necessary. 

Now we ask the intelligent mind of an enlightened profession, if this 
view of the case is not a correct one. We ask the moral sense of a vir- 
tuous profession, if the sanctity of woman's nature should be violated 
by needless exposure ? We say needless, because we believe the specu- 
lum fashion may often drive if s votaries to extravagances, which if they 
do not now, they may soon regret. If the opinion here offered, should 
be proved by the experience of others, to be well founded, and the spe- 
culum specialty loose its hold upon the professional favor of many, the 
worst result that we can anticipate, would be the preservation of a strict- 
er morality, even at the expense of some scientific attainment. 

Another consideration. It may be that symptoms of constitutional 
disturbance, in cases of uterine disorder, are too much overlooked, by 
a constant reference of the mind to the idea of locality in disease, and 
by an application of remedies alone to the organ itself. This is natural, 
and to a certain degree, rational. But a more extended investigation, 
which observes critically the whole constitution of the patient, as it dis- 
plays its Biotic force in the great efferent, and afferent circle, whether of 
nerves, or of circulating tubes, embracing the organic life, from the 
capillary springs, to the great reservoir, which drives the wheels of ex- 
istence, is more likely to result in the good of the patient, and the hon- 
or of science. 

May we not then with fairness, invite the admirers of the speculum 
specialty to study the constitutions of their patients, and to scatter a 
little of their wisdom to their finger ends, and perhaps, in the careful 
manipulations which they may make, healing virtue may be imparted * 



1854.] Parrish — Change of Life in Women. 317 

to the subjects of their counsel, while female modesty shall be saved a 
shock, the tendency of which is to impair, if not to paralyze its strength. 

It would have been inconsistent with our object in communicating 
the series of Essays, of which this is the fifth, to overlook the subject 
we are at present considering. And though it may seem irrelevant to 
some^ we trust the views that are herein announced, may meet with a 
candid criticism, by the honest minds of our profession; and if they 
should be proved to be unsound, no one will be more prompt to re- 
nounce them, than the writer. Having devoted this much space to the 
speculum, and the touch, we may now go on to consider, in order, some 
of the peculiarities of the various changes in female life: We 
shall consider the first change — that which occurs in girlhood. Refer- 
ence has already been made to it, in its natural advent. It becomes us 
now, to point out some of the abnormal symptoms, that accompany its 
appearance, as well as to inquire into its uses, its elements, &c. This 
is necessary to a proper appreciation of the entire subject. Woman her- 
self should know it. She has as much right to do so, as to learn about 
the gastric juice of her stomach, or the bile that is secreted in her liver. 

In Number two of this series, we spoke of the time of the menstrual 
appearance; of its average quantity, of the coincident growth of the en- 
tire organism, as well as of the particular organs concerned in its de- 
velopement. With the general idea already established in the mind, 
that the uterus is the source of the flow, we may now present the ac- 
knowledged theory of its cause, and proceed in course to other subjects 
as they may present themselves. To appreciate this property; we must 
recognize a force — a vis vitale — as we have elsewhere called it, acting with 
an energetic impulse, during every moment of existence, not only to re- 
gulate the growth of the body, but to animate it, and give it the ability 
to grow. As we have already shown, this force exists in all living 
creatures. We have presented it in the seed, the germ, the ovule, in 
speaking of the exhibition of life power, in the developement of the 
special organs connected with reproduction. We must introduce it 
again here, for the sake of applying it. Menstruation, when it occurs, 
is the first indication that there is the ovule, or rudiment, existing in 
the individual, that will enable her to become a mother. 

Dividing the great life force, into the several departments connected 

with life function, we have in the instance before us, the reproductive 

force, of which menstruation is the sign. In its periodicity it resembles 

all living things. What is there in nature that is not periodical ? What 

that does not change ? Menstruation then, proves the existence of an 
30 



318 Original Communications. [July, 

ovule — the ovule contains the germinating principle, and the germina- 
ting principle, when it becomes active, under circumstances favorable 
for developement, produces — and produces from time to time, as the 
tree yields its fruit, or the flower its bloom, and fragrance, when under 
the control of influences designed to evolve its latent powers. 

The human female exhibits this force monthly. The ovary is the in- 
strument through which it is exhibited. It is as we have already said, 
part of the life-force ; that part which developes itself in the generative 
system, and is hence called the generative force. It begins in the ovary, 
because the ovary is the beginning of this particular system. Without 
it, there could be no reproduction. Imagine then the ovary — an ovoid 
body containing a multitude of exceedingly minute vesicles, each one 
distinct in itself, but congregated en masse. Imagine each vesicle en- 
dowed inherently with the power of projecting its contained ovule, and 
this power under the dominion of the law of periodicity, which is seen 
in all animated nature. As the projectile force is being expended at 
the appointed time, all the tissues concerned in the formation of the 
genital system sympathize with the effort. The nerves are more sensi- 
tive; the blood-vessels, already exceedingly abundant and turgid, are 
aroused to greater activity, and in relieving themselves of temporary 
engorgement, exhibit the phenomenon of menstruation. This descrip- 
tion is sufficiently minute to be understood by every intelligent reader, 
and to convey a truthful idea of the fact. It is to be understood then, that 
the menstrual flow is blood. What kind of blood it is, whether arterial, or 
venous, or a mixture of both, is a question that the wise dispute about. 
Some deny its being blood, and call it a peculiar secretion, to be found 
nowhere else. Perhaps it may be. It matters not to us in our pre- 
sent inquiry. Women call it blood, because it looks like it, and it may 
suffice to consider it as such. There is high authority in favor of both 
sides of the question. 

We are now, however, at the age of puberty. We have described in 
a former essay, the changes in developement, both mental and physical, 
occurring at this " critical period. " If those changes do not occur, 
something must be wrong. It is just as unnatural for the girl not to 
change into womanhood, as it is for the woman not to pass the second 
crisis, and become the matron of maturer years. The latter is depen- 
dent upon the former. Suppose there should be an interruption to the 
changes of puberic age, what would be its most probable appearance ? 
Almost every mother can tell. She does not see her daughter of thirteen, 
more or less, running up like a wild stem of the forest, tall, thin, an& 



1854.] Proceedings of Medical Societies. 319. 

tender, without anxiety. She wants to see her grow laterally — spread 
outwards, as well as upwards. And when she sees her thus growing, 
slender and pale, she fears that there is some irregularity of sexual de- 
velopement. Perhaps the demand made by the life-force upon the 
blood, for osseus, muscular, nerve, and membrane tissue, has been so 
great as to deprive the reproductive-force of its share of supply ; and 
hence, with an increase in one department, there has been a correspond- 
ing subtraction from another. Reverse this picture, and the scene is re- 
versed. How shall it be regulated ? This is a simple question, which 
we shall attempt to answer in our next Essay. 
Philadelphia, June, 1854. 

(TO BE CONTINUED.) 



PROCEEDINGS OF MEDICAL SOCIETIES. 



PENNSYLVANIA STATE MEDICAL SOCIETY. 
(abstract or the minutes.) 

The Medical Society of the State of Pennsylvania, held its Annual 
Session, May 31, 1854, at the Court House in the city of Pottsville. In 
the absence of the President, the meeting was called to order at 11 
o'clock, A. M., by Dr. Confer, one of the Vice-Presidents. 

Dr. Condie, of Philadelphia, was appointed Recording Secretary, to 
supply the vacancy caused by the death of Dr. Henry S. Patterson. 

A committee on the credentials of Delegates, reported Delegates 
from Berks, Bradford, Blair, Bucks, Chester, Delaware, Huntingdon, 
Lancaster, Lebanon, Lehigh, Mifflin, Montgomery, Northampton, Perry, 
Philadelphia, and Schuylkill counties; of whom fifty-nine were present. 

The Committee of Publication presented their report, which was re- 
ceived and ordered on file. 

The Treasurer presented his report, showing a balance in his hands, in 
favor of the Society, of $62, and a balance due by the Society on ac^ 
count of printing Transactions of 1853, of $71.86. Assessments still 
due from Erie, Lycoming, Mercer, and York County Medical Societies. 

Referred to an auditing committee, consisting of Drs. Parrish, Van 
Buskirk, and Hale, who reported the same to be correct. 

The following items of unfinished business were reported as appearing 
on the minutes of the last session, namely: 



S20 Original Communications. [July, 

Report from a committee appointed to report in regard to the collec- 
tion of samples of drugs, and preparations. 

Report from committee on gratuitous public vaccination. 

Report from committee on vaccination and preservation of Kine Pock. 

Dr. Hollings worth, on behalf of the Chairman of the committee on 
samples of drugs, etc., tendered an apology for the'non-presentation of a 
report, when, on motion, the committee was continued, with instruc- 
tions to report at the next session. 

Dr. Carpenter, on behalf of the committee on vaccination, and the 
preservation of vaccine matter, stated that the committee had not been 
enabled to prepare, in time, for presentation at the present meet- 
ing, all the materials for their report, but hoped to be able to have it 
completed by the next session. 

The committee on gratuitous vaccination of the poor, reported, that 
in their opinion, the main object originally contemplated by this Socie- 
ty, in appointing said committee to memorialize the legislature of the 
State, for the passage of an act providing for the gratuitous vaccination 
of the poor throughout the commonwealth, may be more effectually se- 
cured through the action of the authorities of the several counties, than 
by the appointment of special officers by the state. In accordance with 
which views, they presented the following resolution. 

Resolved, That in order to extend the benefits of vaccination as far as 
possible among the inhabitants of this commonwealth, the State Medi- 
cal Society urge upon the several organized County Medical Societies of 
the state, to exert their influence to induce the public authorities of their 
respective counties, to adopt prompt measures for as general an exten- 
sion of vaccination, as may be practicable, and to render it imperative 
upon those who are charged with the direction and control of schools, 
public a§ well as private, to require, before receiving any pupil, a writ- 
ten certificate from some properly authorized physician, that he or she 
has undergone successful vaccination. . 

Which resolution was unanimously adopted, and on motion of Dr. 
Betton, the report of the committee was directed to be printed, and a 
copy sent to each of the County Societies in the state, and in counties 
where no Society is yet organized, to the Superintendent of the Public 
Schools. 

The Secretary, Dr. Walker, reported that he had fulfilled the duty 
enjoined upon him by the resolution of last Session, to be found on 
page 16 of the printed minutes. 

A committee, composed of one from each county represented, nomina- 
ted by the respective delegations, was created to nominate officers for 



1854.] Proceedings of Medical Societies. 321 

the ensuing year. The said committee being empowered, also, to select 
the place for the session of the Society in 1855. 

AFTERNOON SESSION. 

The President, Dr. Heister, read the Annual Address. 

On motion of Dr. Jewell, the thanks of the Society were presented to 
Dr. Heister, for his very able address, and a copy requested for publica- 
tion in the Transactions. 

Keports from the Berks and Blair County Medical Societies were 
presented and read, and, on motion, referred to the committee of Public 
cation. 

MORNING SESSION. — JUNE 1, 1854. 

On motion of Dr. Kennedy, a committee was appointed to prepare and 
submit to the next session of the Society, printed forms for county re- 
ports, so worded as to facilitate the preparation of said reports, and to 
secure greater fulness and uniformity therein. Committee, Drs. Ken- 
nedy, Condie, Hollingsworth. 

On motion of Dr. Cassady, a committee on obituary notices of deceas- 
ed members of County Societies was appointed. Committee, Drs. M. B. 
Smith, Carpenter, Mayburry. 

A number of amendments to the Constitution were offered, to enable 
the Philadelphia County Medical Society to re-organize and change its 
title, in accordance with the change in the political organization of the 
county of Philadelphia ; when, on motion of Dr. Jewell, the whole sub- 
ject was referred to the delegates from said county, with instructions to 
report this afternoon. 

A series of resolutions in relation to the preparation of reports from 
County Societies, was presented by Dr. Wythes, and referred to the 
committee on form for county reports. 

Reports from the Medical Societies of the following counties, were 
presented and read, and, on motion, referred to the committee on publi- 
cation — Bradford, Chester, Delaware, Huntingdon, Lebanon, Lehigh, 
Mifflin, and Montgomery. 

AFTERNOON SESSION. 

The Philadelphia county delegation, to whom the subject was refer- 
red, presented the following preamble and resolution : 

Whereas, by the recent action of the legislature of the State of 
Pennsylvania, the city and districts of Philadelphia county have been 
consolidated under one municipal government ; therefore, Resolved, that 
should the Philadelphia County Medical Society consider it expedient 



322 Original Communications. [July, 

to re-organize, and to change its title in correspondence with the new 
political organization of the county, it shall have, when so re-organized, 
all the rights and privileges of the present Philadelphia County Society, 
and that the Constitution of the State Society be amended by inserting 
in the second line of section 2, art. Ill, the words " and from the Phi- 
ladelphia City Medical Society/' 

The said resolution, including the amendment to the constitution, 
were unanimously adopted. 

The committee for nomination of officers reported the following. ' 
President. — Jacob M. GtEMMIll, of Huntingdon county. 
Vice Presidents. — Wilson Jewell, Philadelphia county, 
William Housell, Schuylkill county, 
E. W. Hale, Mifflin county, 
A. K. Gaston, Chester county. 
Recording Secretaries.— -J). F. Condie, Philadelphia county ; 

H. Carpenter, Lancaster county. 
Corresponding Secretary.— Soma Neill, Philadelphia county. 
Treasurer. — Francis West, Philadelphia county. 

CENSORS. 

1st, and 2d, Districts. — -J. B. Biddle, Philadelphia county ; John T. 
Huddleson, Delaware county ; Hiram Corson, Montgomery county ; P. 
Cassady, Lancaster county; William Grries, Berks county ; Charles H. 
Martin, Lehigh county ; K. E. James, Northampton county ; Gr. F. 
Horten, Bradford county. 

3d, and 4:th, Districts. — Thomas Wood, Lycoming county; J. B. 
Luden, Huntingdon county ; Joseph Henderson, Mifflin county ; Wm. 
H. Mcllvaine, York county ; J. H. Case, Perry county. 

5th, and Qth, Districts.— I. P. Grazzam, Alleghany county ; W. An- 
derson, Alleghany county; James Dickson, Alleghany county ; C. F. 
Perkins, Erie county ; John T. Ray, Mercer county. 

DELEGATES TO AMERICAN MEDICAL ASSOCIATION. 

J. P. Heister, Berks county ;W. H. Townsend, Chester county ; Chas. 
Innes, Northampton county ; John Gr. Koehler, Schuylkill county ; 
J. H. Dorsey, Huntingdon county ; Henry Carpenter, Lancaster coun- 
ty ; John A. Martin, Montgomery county; David Moses, Lehigh county ; 
James Gralbraith, Perry county; Jacob M. Confer, Blair county; R. K. 
Smith, Delaware, county; John Dyer, Bucks county; Joseph Hender- 
son, Mifflin county. 

The committee also reported, that they had selected Hollidaysburg 
for the place of meeting of the Society in 1855. 



1854.] ' Proceedings of Medical Societies. 323 

The committee was continued with instructions to nominate the ad- 
ditional members of the committee of publication. 

Reports from the following county Medical Societies, were presented 
and read, and, on motion, referred to the committee of Publication, 
namely, Perry, Philadelphia, and Schuylkill. 

The committee on nominations reported the following gentlemen to 
constitute, with the Recording Secretaries and Treasurer, the committee 
of Publication: — Francis Gr. Smith, Samuel Lewis, Robert P. Thomas. 

The committee on obituary notices, presented a report, with the fol- 
lowing resolution, which was adopted : 

Resolved, That the several County Societies, be earnestly solicited to 
append to their annual reports to the State Society, brief notices of such 
of their members as may have died during the year. 

Dr. Parrish, on behalf of the Chester County Medical Society, pre- 
sented the following questioDS : 

1st. Does dysentery prevail most in those sections of country in which 
there is little or no iron in the soil ? 

2d. Do paralysis and other nervous diseases, prevail most in those sec- 
tions of country in which iron is diffused through the soil ? 

3d. Does the clearing off of the timber, tend to increase affections of 
the nerves and of the intestines — and if so, why ? 

On motion, referred to a special committee — Drs. A. K. Gaston, W. 
M. G-uilford, A. Hoger, L. E. Kitchen, Charles E. Hoffman. 

Dr. Corson presented the following resolution, which was referred to 
the committee on forms of county reports. 

Resolved, That it should be distinctly stated in those county reports, 
in which reference is made to the influence of limestone formations in 
the production or modification of diseases, whether the limestone lies 
near the surface, or at a great depth, and if the latter is the case, what 
covers it. Also, whether the water used for drinking and cooking is 
impregnated or not, with calcareous matter. 

Dr. R. K. Smith, presented a resolution which was adopted, that the 
preamble and resolutions of Dr. Emerson, adopted in 1852, and re-adopt- 
ed at the session of 1853, be printed, and a copy sent to each County 
Society now organized, and in those counties where no County Society 
exists, to such members of the medical profession as the Secretary may 
select, and that the expense of carrying this resolution into effect be 
assessed upon the county Societies. 

Dr. W. T. Bladen presented a resolution approving of a black list, 
adopted by the Medical Society of Reading, which, on motion, was laid 
on the table. 



324 Original Communications. [July, 

A list of the officers and members of the Lancaster County Medical 
Society was presented, and ordered on file. 

On motion of Dr. Walker, the Constitution and By-Laws of this Society 
and the Code of Ethics, were directed to be appended to the next volume 
of Transactions. 

On motion of Dr. West, the committee of publication were instructed to 
append to the title page of the Annual volumes of Transactions, a dis- 
claimer, on the part of the State Society, of any responsibility for the 
facts and opinions contained in the addresses and reports published there- 
in, as having been read before the said society. 

On motion of Dr. Thomas, the resolution offered by Dr. Emerson at 
the last session, and indefinitely postponed, (see page 16, printed min- 
utes) was taken up and passed. The resolution has reference to the 
presentation at the sessions of the Society, of abstracts of reports over 
fifteen pages in length. 

Resolutions in reference to the death of Dr. Francis S. Burrows, of 
Lancaster, one of the Vice-Presidents of the Society, of Dr. Henry S. 
Patterson, of Philadelphia, one of the Recording Secretaries, and of Dr. 
Joseph D. Stewart, of Philadelphia, were presented, and unanimously 
adopted. 

On motion of Dr. Sniith/»it was unanimously Resolved, That the of- 
ficers' named in the report of the committee of nomination, be declared 
the officers of this Society for the ensuing year. 

Votes of thanks were tendered to the President and officers for the 
able and courteous manner in which they performed their duties ; to the 
Commissioners of Schuylkill county, for the use of the very beautiful 
and commodious room in the Court House at Pottsville, for the meetings 
of the Society; and to the medical profession of Pottsville, for the cor- 
dial and hospitable manner in which they provided for the accommoda- 
tion of the sessions of the Society, and their attention to the members. 

The Society then adjourned, to meet in Hollidaysburg, on the last 
Wednesday in May, 1855, at 10 o'clock, A, M. 



1854 J Biblioyraphical Notices. 325 



BIBLIOGRAPHICAL NOTICES. 



WtiMAN ; Her Diseases and Remedies. A series of letters to his class, 
by Charles D. Meigs, M. D., Professor of Midwifery and the Dis- 
eases of Women and Children, in the Jefferson Medical College of Phi- 
ladelphia ; member of the American Medical Association ; of the 
American Philosophical Society, and of the Council ; Vice-President 
of the College of Physicians of Philadelphia ; late, one of the Phy- 
sicians to the Lying-in Department of the Pennsylvania Hospital, &c. 
Third edition, revised and enlarged : Philadelphia. Blanchard and 
Lea, 1854. 

We have spent some hours over this book,, arid they have been hours 
of much interest. It is a book remarkably characteristic of its author. 
If there was no other " sign," as a way-mark to point to him, but this, 
the traveller that would look and read, might easily know " what manner 
of man he is." Perhaps we may call it a scientific novel," found- 
ed on fact." Midwifery poetized, will be a better name. Not rhymed 
—but dotted all through with 

" Rich carvings, portraitures, and irnagery." 

Familiar letters to his class, and familiar dialogues with his patients, 
constitute the style of the work. Its material is wrought out of the 
mine of experience. The lore of sages long buried, arid yet living, is 
taken in pearly parcels, from the store-house of ancient and modem 
obstetrical literature, to garnish and attract ; while substantial and en- 
during truth, developed, and confirmed by long labor in the profession, 
furnishes the corner stone of the structure. Some people find fault 
with the book. It is thought to be too conversational ; and then the 
great idea meant to be inculcated by it, that the people have a right to 
know for themselves, what is the pathology of their diseases, and what 
the treatment, is objected to, because it popularizes the science of medi- 
cine, and brings it down to the common sense of the people. The truth 
is, the common sense of the people is rapidly coming up to the point, 
at which even the most profound doctor may stand, and in contemplat- 
ing the range of his intellect, confess that all men have an equal right 
to the boon of knowledge. 

We would not insinuate that our author is a leveller, in the common ac- 
ceptation of the term, but that he recognizes in the book before us, the 
40 



326 Bibliographical Notices. [July, 

growing intelligence of the people, and prescribes, and converses, as with 
intelligent beings. It seems to be his aim to secure a positive submis- 
sion to his professional advice, by convincing his patients of the propri- 
ety of his counsel, rather than by enforcing obedience by the acknowledg- 
ed supremacy of professional authority. 

In this, we think there is wisdom. We judge from our own limited 
experience, especially with inquiring female minds. Faith and obedi- 
ence, cannot take the place of the reasoning and investigating propensi- 
ty, in matters connected with one another. It is hard enough to bring 
them to bear upon subjects that have their relation with the unknown, 
and unseen. Alas ! how little do they act, even here. Dr. Meigs be- 
lieves that quackery finds its most fruitful source, in the darkened minds 
of the people; that it enjoys a blind credulity, and revels, where igno- 
rance flourishes. Ignorance of medicine — not a general want of infor- 
mation. Perhaps he is right. We are inclined to think he is. Hence, 
he makes his patients his students ; students at least of themselves, and 
thus they are disciplined, as well as dosed — trained to keep well, while 
cured of being sick. So much for this feature of the book. The dis- 
eases of women are presented in the familiar, and yet poetie style refer- 
red to, with a good deal of detail. Prolapsus uteri is treated of as a 
dislocation, and the treatment recommended, the same as that for other 
dislocations,-^-by rest, splints, &c. The pessary is preferred to external 
support. It is the splint for this kind of dislocation, after the uterus 
has been placed in situ. 

We are glad to have the authority of Dr. Meigs, in favor of views 
already presented in this Journal, on the speculum practice. He calls 
the use of the speculum uteri, a " flagrant act — an act inexcusable, save 
under the duresse of a conviction that it is needful for the Safety of the 
woman." Again, " I am convinced that a very experienced or erudite 
touch, a tactus eruditus, can often report to the practitioner's intelligence, 
all that he shall require to know of the case." And yet in cases requi- 
ring it, the speculum is advised, and minute directions given how to use 
it. We could enumerate many points of value, and great interest, to be 
found among the six hundred and sixty-six pages of this volume, and 
perhaps some, to which we might make objection, but we have neither 
time nor room, and must forbear. All who want to preserve a portrait- 
ure of an eminent writer, and lecturer on this subject, that is true to the 
life, should get " Woman and her Diseases," by Meigs. 



1854.} Bibliograpical Notices. 327 

The Science and art of Surgery ; Being a Treatise on Surgical 
injuries y diseases, and operations. By John Erichsen, Professor 
of Surgery in University College, and Surgeon to University College 
Hospital. Edited by John H. Brinton, M. D. Illustrated by three 
hundred and eleven engravings on wood. One vol., pp 908. Phila- 
delphia, Blanchard and Lea. 

Mr. Erichsen has given us in this work, a most complete synopsis of 
the " Science and Art" of Surgery; such as renders it worthy of a high 
place among the numerous text books upon the subject. Whatever dif- 
ferences of opinion may arise, in regard to the " Science" of the patho- 
logical ideas of the author, few, we think, can object to the mode ill 
which the "art" is practically advised. 

We would especially call attention to the second chapter oil " Gene* 
ral considerations on operations." In this, as in many other places, we 
discover that the author ranks with the conservatives in Surgery. "The 
practice of operating, he says " in notoriously hopeless cases, with the 
view of giving the patient what is called a last chance, is much to be 
deprecated, and should never be done. It is by operating under such 
circumstances, especially in cancerous diseases, that much discredit has 
resulted to Surgery ; for, in a great number of instances the patient's 
death is hastened by the procedure ; which instead of giving him a last 
chance, only causes him to be despatched sooner than would otherwise 
have happened." 

Chloroform is the anaesthetic agent, advised unequivocally, to the ut* 
ter exclusion of ether, which the American editor says, is now generally 
employed in this country, as it is thought to be less dangerous. Nation* 
al prejudice, and the extraordinary chloroform statistics of the London 
Hospitals, are sufficient to account for this preference ; but we should 
have thought ether at least worthy of mention. The chapters upon the 
blood-vessels, are particularly full, and the entrance of air into veins ia 
discussed at length. The author says that he is satisfied that death oc- 
curs in these cases " in consequence of the air and blood being beaten 
up together in the right cavities of the heart, into a spumous froth 
which cannot be propelled through the pulmonary vessels : Hence, there 
is a deficient supply of blood to the brain and the nervous centres, an<} 
fatal syncope comes on, attended usually by convulsions." The prac-s 
tice of applying ligatures to the distal, as well as the proximal side of a» 
wounded artery, is strongly urged. In regard to fractures, we shall on- 
ly notice the opinion of Mr. Erichsen as to the use of the starch band-? 
age, which we think is well worthy the attention of American Surgeons, 
He says that " until the past year, he did not thin]* it safe practice to, 



328 Bibliographical Notices. July,] 

have recourse to it until the swelling of the limb had begun to subside/' 
but that latterly he has followed the plan of Leusin's, in at least fifty or six- 
ty fractures of all kinds, putting the limb in the starch apparatus immedi- 
ately upon the occurrence of the injury, and has found the practice ex- 
tremely successful, as he thinks " that the moderate pressure of the band- 
ages, aided probably, by the great evaporation that goes on during the 
drying of so extensive and thick a mass of wet starch, and which pro- 
duces distinct sensations of cold in the limb, takes down the extravasa- 
tion most effectually, and enables the patient usually, to leave his bed 
about the third day after the injury ; when the fracture is in the leg or 
ankle, and about the sixth, when it is the thigh that is broken." 

The chapter on aneurisms, is especially worthy of attention, and the 
subjects of diseased bones and joints, are much more fully treated of 
than is common in works of the kind. To particularize much more, 
would extend a notice like the present, to too great a length, but we 
cannot forbear quoting the author's opinion in regard to the feasibility 
of a practice much advocated by some of the profession, — that of cauteri- 
zation of the larynx. 

After remarking that the practice is spoken of "as if this were a pro- 
ceeding that could be adopted with as little difficulty as passing a sponge 
into the nares, he says, "that not only does physiology and ordinary 
experience, tend to disprove the possibility of such a procedure, but re- 
peated experiments, both on the living and on dead subjects, have led 
me to the conclusion that it is utterly impossible to pass a whalebone, 
whether curved or straight, armed with a sponge, beyond, or even between, 
the true vocal cords. And further, " I have little doubt that in those 
cases, in which the sponge has been supposed to have passed between 
and beyond the vocal cords, and in which the operator speaks of having 
felt the constriction exercised by these, in its entry and exit, it has in 
reality not entered the larynx at all, but has been passed behind this 
tube, into the aesophagus, the constriction being produced by its pas- 
sage beyond the projection of the thyroid and cricoid cartilages, and 
that the caustic solution has been applied to the mucous membrane in 
this situation, instead of to that lining the interior of the air passages/' 

The latter part of the book is devoted to the diseases of, and opera- 
tions on the genito-urinary organs, which are treated of very explicitly. 
Before closing our notice, we must be allowed to repeat, that this is de- 
cidedly one of the best text books yet issued. Dr. Brinton has incorpo- 
rated with the text almost all that is important or peculiar to American 
Surgery, and has thereby greatly enhanced its value to the American 
student. W. H. 



1854.] Mlitorial. 320 



EDITORIAL. 



THE CHANGE IN THE MEDICAL LAW. 

These are wonderful times. Times of great adventure. Times, when 
men are free to risk much that is valuable in trade and commercial spec- 
ulation ; and strange to tell, when some prefer to sustain the opinions 
and practices of the ignorant, the pretending, or the knavish in medi- 
cine, to the sterling, long-tried, and still enduring truths of science. Enr 
terprise in commerce, and the heels-over-head fashion that marks the 
spirit of trade, has certainly found its way into some departments of me- 
dicine. These disturbed, and disturbiog elements, with their noise and 
glitter, have some how got hold of the legislative heart of New Jersey. 
We will not say mind, for legislators at Trenton, have not within a 
few years, exhibited many qualities, that would indicate the possession 
of much capital of this sort ! though we freely admit, they have shown 
some heart in their work. They have much heartfelt sympathy with 
party interests, — they have much of it with those miserable factions in 
society where rum is the ruling spirit, and where legislators who are fond 
of the " creature/' or of the votes of his bondmen, are the "gods" that 
are worshipped under his inspiration. Such is the lamentable truth. 
It is no marvel then, as year after year, they have resisted the cries and 
prayers of thousands of their constituents, who have asked that they 
should remove a great curse from their midst; that now, in the hour of 
their wicked triumph, they should put their heel upon the long ac- 
knowledged law that has declared empiricism in medicine, illegal.. But 
they have done it, and who will suffer? Not the medical profession cer- 
tainly, for that has a firmer basis than legislative authority. Not the 
Medical Society certainly, for that existed before the State, and had. its 
foundation in moral and scientific truth. Its code is more enduring, than 
the statutes of the commonwealth, and its interests so identified of ne- 
cessity, with the interests of the people, that the faint breath of an 
ephemeral legislation may not dissipate it. Whence then, the cause of 
complaint ? It is here. The standard of morals is lowered by opening 
wide the door to advertising quacks to come in, and filch the pockets of 

I •. ■ 



330 Editorial. [July, 

the unwary, for the poor privilege of drenching their stomachs with se- 
cret nostrums, by the quart. The principle is a wrong one, as the prac- 
tice of it is daily proving. The elevated position that science has 
long held, and always will hold, has received a thrust from the hand of 
legislative authority, which indicates a want of intelligence in law ma- 
kers, that must impair their influence, and usefulness. But the excuse 
is, that the broad philanthropy, and enlightened democracy of the 
New Jersey legislature, could not acknowledge the principle of confer- 
ring special privileges. In New Jersey, that ought not to be tolerated. 
They would not sanction a monopoly in medicine. Oh, no ! monopolies 
are obnoxious to Jerseymen. This was never asked of them. Had it 
been offered, it would have been spurned. The medical laws of New 
Jersey, were not instituted, or sustained as a protection to the Medical 
Society. They conferred upon it no more actual benefit than it now enjoys. 
But their object was to protect the people from imposture; to testify in 
favor of scientific medicine. The profession was not the better, but the 
people, for these regulations. The medical mind, in its investigations 
after truth, was not a whit strengthened by the legislative countenance ; 
but the people's health, and purses were in a measure kept put of the 
hands of intruding emperics. Now, the tables are turned, and every 
body who can buy a parchment from a pseudo-College, may go to New 
Jersey, by invitation of its legislature of 1854, to practice deception. 
Perhaps the Legislature congratulates itself, that the first stroke has been 
given to "monopoly" in the State of New Jersey. They called the Medical 
Society by that name, so odious to Jerseymen, and they have attempt- 
ed to purge it of its sins, but have unfortunately taken the bitter dose 
themselves ! They were cunning men, who managed this affair. Not 
wise, for a wise man has said, what all history has confirmed, that 
" Cunning is the Ape of wisdom." 

They stood before the credulous, legislature, and asked it, as the 
crafty, low-minded boy asks his playmate, to shut his eyes, and open his 
mouth -j and while expecting to get a sweet morsel, the bitter draught 
was thrown down his wide, and willing esophagus. 

We know the people of New Jersey well enough to believe, that their 
good sense revolts at this little piece of State-House trickery. We fear 
only for the honor of law, and the beauty of moral principle, while we 
shudder at the knavery, and pretension of those, who for want of hon- 
esty enough, or knowledge enough, have sought this means of gaining 
access to the people. 

What shall the profession do ? is a question not unfrequently asked. 



1854.] Editorial 331 

Shall this ignorant legislation go unnoticed by the Society, whose re- 
putation, and usefulness, it is intended to impair ? We will not answer. 
Though we may not refrain from expressing our individual belief, 
that it ought not to be resisted, except by the honest expression of op- 
posite principles. This, the Society, it seems to us, might do, with 
perfect consistency. Indeed, it is a question whether it does not owe it 
to the public, and to itself, to make a plain statement of its history, its 
object, and its conservative policy, and submit to an intelligent citizen- 
ship, the examination of the whole subject. If the people prefer to open 
the State to all kinds of pretension, and fraud in medicine, let them do 
it, and let the Medical Society respond Amen ! after it shall have de- 
clared its own principles, and its determination to maintain them. A 
dignified protest against this unwise, and to be repented of proceeding, 
may well become the venerable Association, that for nearly a century, 
has sought the firm establishment of scientific medicine in New Jersey, 
— but nothing more. We should regret to see any controversy with 
misguided people, or unsound, and unsafe systems. Contact itself 
Would be vile. We would rather elevate the cause of true medicine 
above the reach of petty — crawling — slimy empiricism, and let it stand, 
too proud to bow, save to the ever extending, and conquering sceptre of 
truth and Science. P. 



Mg* We would invite the attention of our New Jersey readers to the 
6all for a special meeting of the Medical Society of New Jersey, on 
Tuesday, the 11th instant. 

Business of importance bearing on the interests of the profession, and 
of the public will be brought before the Society, and it is to be hoped 
that there will be a full attendance. 

Delegates to the Annual Meeting in January last, hold office until 
new ones are appointed. 



Jl^* We have been disappointed in not receiving the fifth of the series 
of articles on the History of the American Medical Association, in sea- 
son for the present issue. It may be expected in our next, together 
with the portrait and biographical sketch of John C. Warren, M. D., of 
Boston. 

We have several articles on hand for our next number. 



332 Editorial. [July, 



WELCH'S SPLINTS; 

We have recently procured a set of these Splints, the invention of 
Benjamin Welch, M. D., of Lakeville,- Conn. We have, as yet, had no 
practical experience with them, but they possess features which commend 
them to the attention of Surgeons. Their peculiarity consists in the com- 
bination of the firmness of woody fibre with the elasticity of gutta percha. 

" The Splints consist of light and elastic cases or coverings, formed 
of very thin strata or layers of wood or ' cut veneers/ cemented togeth- 
er by interlayers of gutta percha, of such thickness as is required to 
maintain their form, and pressed into the form of the part for which 
they are designed." * * * * ■ * 

" This may be introduced in any proportion required to give strength 
and durability and resistance to the action of fluids, and when properly 
applied, it adheres with more firmness to the wood, than the fibres of 
the wood do to themselves. Another circumstance attending this ar- 
rangement, of considerable practical importance is, that the Splints are 
made more flexible and elastic in the lateral or parallel direction of the 
fibres of the wood, than in the longitudinal; hence, what may seem 
somewhat paradoxical, they readily accommodate themselves to changes 
in the dimensions of the limb, resulting from increase or diminution of 
inflammation, of from interstitial absorption, while they give ^perfect 
support to the injured or diseased part. When necessary to adapt them 
to limbs of individuals differing in the form and size of their limbs, they 
are made sufficiently flexible by immersioa in hot water, or simply en- 
veloping the Splint, or such portion of it as may be necessary, in cloths 
Wet with hot water for a few minutes, and then, on cooling, they will 
immediately become unyielding and elastic as before. This peculiarity 
can scarcely be too highly appreciated, for of all the materials hereto- 
fore proposed capable of being moulded to the part and hardening after 
the Splints are applied, none has been found which has not proved de- 
cidedly defective in practice. They possess great strength and durabili- 
ty, so that the same Splint may be used a long time, and for the treat- 
ment of many cases of fracture. They do not preclude the use of evap- 
orating lotions, water-dressings, or moisture, in any manner applied, ex- 
cept when heated much above the temperature of the body. They are 
applied with great facility, rendering the dressings simple and easy to 
both surgeon and patient, and allow constant access to the injured part, 
to detect inflammation at its commencement, or any irregularity in the 
position of the bones ; and after the tendency to inflammation has sub- 
sided, dressing or examination by the surgeon is required much less fre- 
quently than when ordinary Splints are used. In short, they have com- 
bined with the property of being made sufficiently soft and yielding to 
be moulded, with accuracy, to the surface of the part for which they are 
designed, all the properties of insolubility, lightness, elasticity, strength, 
and firmness, necessary to constitute a perfect Splint." 



1854.] Eclectic and Summary Department. 333 



ECLECTIC AND SUMMARY DEPARTMENT. 



On -a New Mode of Removing the, Placenta. By Thomas SchneedeK, M. D.— To the 
Editor of the Peninsular Journal : Dear Sir, — The following article, which I have been 
persuaded to send to you for publication, is part of an essay which was read before 
the Medical Society of Chicago. As I am not yet fully acquainted with your language, 
having been in this country less than a year, I trust you will excuse its imperfections* 

If we fix upon a table with the hand or a weight, a fresh placenta, and seizing it 
with a pair of wide bladed forceps, either by its margin or at the attachment ol the 
cord, turn them once or twice round, we observe that the bulk of the placenta is di- 
minished, and its strength increased so that we have to use more force to tear it apart. 

We find also that We are able to push the placenta through a hole made in a board, 
by twisting it through, which nd force could make it pass in any other manner, without 
laceration. 

I think that we may with advantage, make use of these two facts in cases where 
other means of removing the retained placenta have failed, or where severe hermor* 
rhage require its immediate removal. For instance, when the placenta is retained by 
spasm of the uterus, two fingers are to be introduced which seize a portion of the pla- 
centa. The forceps are to be applied to this portion, turned once or twice rdund, 
and moderate traction Used. 

Should we not succeed in overcoming the spasm, the two fingers hold the twisted 
portion of the placenta in its position, and the forceps are applied higher up. Thus 
the placenta diminished in size, and rounded, dilates the os uteri more equally than 
the fingers, and its ability to endure traction is much increased. 

Should the uterine surface of the placenta present itself, we should, if possible, 
change its position so as to be able to apply the forceps to the margin. The same pro- 
cess maybe used in an hour-glass contraction as well asin adherent placenta, natural- 
ly without using any traction in this last case. 

As the periphery of the adherent placenta by twisting it is slightly moved toward 
the center, the adhesions will easier yield to the separating hand, and the danger of 
laceration or inversion is less. 

If we had to remove a very fragile placenta, we might surely and successfully have 
recourse to this twisting; and finally, we must apply this method when the placenta 
is retained after abortion, other means of removing it having been unsuccessful. 

Though I have no certain proof for my idea in regard to the first mentioned cases, I 
remember a case of abortion, where, by this proceeding, I evidently saved a life, 
which case I will in short relate. 

Having been called to a woman that had an abortion in the fourth month, was told 
by the midwife, that three days previous the abortion had taken place, that the placen- 
ta had not been naturally expelled, nor had she herself been able to remove it; and 
that some horns before my arrival a severe flooding had taken place which had re-ap- 
peared whenever the patient recovered from fainting."* The funis was torn off, and the 
midwife had removed as much of the placenta as she had been able to reach, so that 
I could onlv just touch some of the remaining part. 

43 " 



33<1 Eclectic and Summary Department. [July, 

I ordered applications of cold water both internally and externally, and a strong 
dose ofergotine, and went home for a proper pair of forceps ; but the husband came 
running after me, and informed me that I would probably find his wife dead, as the 
hemorrhage had become worse than ever before. 

When I came back, without trying to revive the patient, I immediately introduced 
my hand and seized with the forceps as much of the placenta as I could reach. For 
three several times, however, I could only remove small portions, but was at last able, 
by applying the above mentioned method, to remove the whole. 

It is not in slight eases that I Would advise this method of twisting the placenta, 
though even then it might be used successfully; but where danger is urging, variotfs 
other means having failed, it seems to me a method not only theoretically true, but 
practically useful. 

On the different modes of delivery, I have read Naegle, Siebald, Scantzony, Cazeau, 
Lievee, Ramsbotham, and Churchill, without finding mentioned the twisting of the 
placenta; therefore I call this idea a new one. Whether it will prove a good one, 
experience will show.— Peninsular Journal of 'Medicine. 



Quinia and Tartaric Acid in Intermittent Fevers. By Drs. Bart£lLa and Bastille. 
(MedicdChir. Review, in Ranking's Abstract.) — "Two years since, M. Bartefla 
brought forward his plan for the more economical treatment of ague, by administering 
equal parts of sulphate of quinia and tartaric acid. He now {Butt, de Tfterapeiitique, 
torn, xfv., p. 49) reinforces his former statement by new facts, having treated altogether 
208 cases in this way, 196 of these being simple intermittents, and 12 pernicious 
fevers. 

" Dr. Bastille, who has been pursuing the same experiments, states, as his conclu- 
sions (Gaz. des Hop., No, 87,) — 1 ; That sulphate of quinia, given with equal part's of 
tartaric acid, is moie active than the simple sulphate; 2. As a general rule, half the 
quantity of quinia so combined suffices; but, in some descriptions of fever, as in the 
pernicious ones of Italy, larger doses are required." — Charleston Medical Journal. 

Hints for young Doctors. By G. D. Ghiswold, M. D., of New York—For ten years 
I have led a somewhat variable and busy life, always devoted to the interest of my 
patients — when I had them to care for — and my profession : yet notwithstanding my 
predelictions for the use of the pen, I have seldom contributed anything of my expe- 
rience, or inexperience, to strictly professional journals; preferring always to read for 
my own instruction, rather than to write for the information of others. The principle 
is wrong, although it is better to be silent than to affect to be overwise. 

How much more attentively we watch the different phases and behavior of a dis- 
ease, when it is our intention to report it — how much more definitely each symptom 
is impressed upon the memory: and with what readiness its stages and the treatment 
may be re-called at any time afterwards. In this way a habit becomes confirmed, 
and holds good in all cases. In traveling, formerly, I noticed everything for the pur- 
pose of giving a description. Nauvoo Temple has long since been crumbled to the 
earth ; yet the peculiarities of that structure, and the ground and beautiful scene I 
looked oufl» upon from its tower, are still distinctly visible in my recollection. The 
habit of observation thus formed, has led me ever since to the upper deck of a steam- 
boat, or the top of a stage coach, that I might look out ; and to detest cars, because 
4hey shut me up, 

There is more utility in thfs habit of close observation, than most physicians are in- 



1854.] Eclectic and Summary Department. 335 

elined to acknowledge in practice. I can remember distinctly the details of cases 
that I attended years ago, with the moidfications in the treatment to meet indications 
; — I held in view, and do still, intend to publish them — and yet I have by no means a 
retentive memory upon general subjects. 

This habit any one can acquire by proper discipline, and it is one exceedingly im» 
portant to the physician. The young physician who writes out his cases, will be 
most sure to read the reports of others, and in this way his experience will be trebled 
in value, besides most likely escape that worst of all obstacles to progress, routine 
habits of practice. 

In reading your Journal, which I always do with interest, I seldom pass over the 
report of a case; and if I know it to be from the pen of a young physician, I peruse it 
with a sort of "do by others as you would that they should do by you" principle — re« 
spect and encourage them by reading their productions, as we would cherish the me- 
mory of one departed — although both alike are oblivious to our good intentions. In 
this way we not unfrequently fall in with good ideas, which like seed sown, spring 
up at a future time and multiply. 

As 1 shall have no room in this for a "report," as I had intended, I will add one 
other hint for such of your readers as may be younger than myself, and put off the 
" case" to another day — or rather night. 

In the first place, write out all your important cases ; if time will not admit its being 
done immediately, keep thinking them over with that intention. When this is done, if 
you find any of them to contain facts which you believe to be of value, send them to 
a publisher, post paid. Do not make the mistake that many young writers do, by 
sending to the largest and most important Journals, for such are usually supplied with 
more matter than they can print; and therefore, in all probability, in such a case your 
production would never find a place in their pages, and you would most likely get 
discouraged with the first attempt. On the contrary, send your articles to a small 
Journal first, or to a new one that has little patronage — of which there are an abun- 
dance thankful for small favors ; and in order that you may be sure to see them if 
printed, it is a good plan to enclose the subscription price with the production, and 
but very few if any comments, aside from your name and address plainly written. 
Draw no inferences on your cases — your readers will do that, and save yqu your time, 
and paper, and likely enough no small amount of future regrets — but simply the med- 
ical facts, plainly and concisely stated. Remember, if you have any desire to see 
your article reprinted in other Jouanals, that it never will be \ihng. Follow these 
rules perseveringly, ar^d you will ultimately not pnly succeed as authors, but as goo.l 
physicians- 

A regular medical man told me, not long ago, that he subscribed for but one Jour- 
nal — and that I will not mention— which he never found time to read. i Now I shall 
remember this man as long as I do the Nauvoo Temple, for I have a habit of remem- 
bering such " cases." I shall never apprehend, on meeting him, that he has seen 
this comment for did he read this Journal he would know better than to make such a 
statement. 

I remember calling on Dr. John W. Francis, late one evening, and finding him in 
bed, he not being very well; yet his light was safely arranged, and within reach there 
was reading matter enough to last all night. If there is no other time, an hour may 
be spent nearly every night in reading, before the eyelids drop; and he who cultivates 
his intelligence, as a physician should, will improve even this hour, if he has no other. 
If you do not read, never tell of it, for it is more creditable by far to have time io\ 
|his, than too much business.— Boston Med. and Surg. Journal. 



336 Eclectic and Summary Department. [July, 

Use of Secale Cornutum in Hemorrhage. — By A. I, Cummings, M. P. —For some 
length of time I have used the pulverized ergot somewhat extensive] y, not only as a 
stimulant to the uterus in parturition, but as an astringent, either direct or operating 
through the agency of the nervous system. Especially in cases of hcemorrh agi i from 
the bowels, arising from dysentery or other causes, I have often seen the most decided 
and permanent results from its exhibition. In numerous cases, which could be given 
jin detail, were it necessary, I have seen the ergot produce the most prompt and satis- 
factory effects in immediately checking the sanguineous effusion, and, in many cases, 
the effect has been permanent. In hcematemesis<, also, I have seen the most decidedly 
beneficial results from the use of ergot. In one severe case, which had for a long 
time resisted powerful remedies, it was used in substance, by my direction, and 
proved completely effectual. 

In one case only oihamoptysis have I used the ergot, and the results in that case 
were sufficiently satisfactory to insure my confidence in it, as an agent, worthy of trial 
at least, in other cases. It is my intention to test it more thoroughly as a remedy in 
the treatment of haemorrhage from the lungs. But especially in haemorrhage from ll,e 
stomach and boivels, 1 have confidence in its practical value as an astringent. Though 
it should not, in my opinion, supersede entirely the use of tannic acid, gallic acid, 
acet. plumbi, and other well known and truly valuable articles, when an astringent is 
necessary, yet, in combination with other articles, or in cases where other agents fail, 
the ergot will be found valuable. It may be given in powder, in doses of from two to 
ten grains, repeated as often as is necessary. Its use is contra-indicated, of course, in 
pregnant females, I intend to make further experiments with the ergot in cases of 
haemorrhage, as I may have opportunity. 

Does the ergot operate through the nerves in haemorrhage from the bowels, as it 
manifestly does in uterine haemorrhage, in which it is so valuable?— -Boston Med. awtl 
fiurg. Journal. 

Incompatibles. By Charles Willtam Weight, M. D., of Cincinnati, — The foikrw- 
fng table contains, it is believed, all the information on the subject of incompat> 
bles that will ever be of much value to the physician and medical student, 

TABLE OF INCOajEATIBLES. 

5 Alkalies, 
Alkaline earths, 
All carbonates.^ 
Alkalies and their carbouates, (Soluble metalic salts, as the sulphate of iro^. 
Alkaline earths. (Also the fixed oils. 

( Soluble salts of lead, 
Sulphuric acid and soluble sulphates. < " " mercury. 



antimony. 



Hydrochloric acid, V a > vi n n i 

pli •!„ ~ - t ' ' **■ ' J So uble salts of ead. 

Chloride of sodium, < i; a ., 

Iodide of potassium. ( silver. 



rSolut 



lble salts of iron, 
" silver. 

Tannic and gallic acids. ^ * " lead. 

" " copper. 

(^ " " * antimony. 

yjy, . (Tinctures of substances whioii are not soluble in water to any grcal 

(extent, as tincture oi iodine. 

* Prussie acid is not incompatible with the carbonates, but all olher acids are. » 



1854.] Eclectic and Summary Department. 337 

„. (Solution of all substances which are insoluble in alcohol, as a solu- 

Iinctures. ^ pa Q f g Um ara bj Cj mucilages, &c. 

Salts containing the same acids, or the same bases, are not, as a general thing, in- 
compatible with each other. Thus the sulpate of potash is not incompatible with the 
sulphate of soda. Neither is the sulphate of potash incompatible with the nitrate of 
potash. Any two substances which contain the materials for forming an insoluble. 
body, are incompatible with each other. Thus carbonate of soda and nitrate of silver 
when brought together in solution, form the insoluble carbonate of silver. 



T/ie Practice of Medicine in China. — I? Union Medicate copies from a Russian jour- 
nal, the following remarks on the teaching and practicing of medicine in China: — 

In China, Medicine is not taught in special establishments and no examination is 
necessary in order to practice medicine. Whoever finds the vocation convenient 
practices this art from interested motives. 

It is true, that for two hundred years, there has been a regulation concerning the 
practice of medicine, according to which, the candidate for the degree of Doctor of 
Medicine must undergo an examination, that is to say,. must write a thesis on some 
proposed subject. If, after two examinations he received a favorable note, he was 
received as a physician to the court. But now the examinations are a form, and hon- 
orable positions are obtained by favor. 

From all time, medicine in the Celestial Empire, has held a middle place between a 
trade and an art. In the villages and unimportant cities, the earliest inhabitant is the 
astrologer and doctor. Go into any street you please, on all sides, signs are hung out 
at the windows and doors, with the name of the doctor, and gratuitous certificates of 
friends who boast of his talent. 

In the street where the hotel and convent of the Russian Mission are situated, (in a 
quarter of a mile), nine of these signs may be counted. 

These out-door Esculapians are, for the most part, persons who have been obliged 
by circumstancees to change their business, for example, dismissed functionaries, su- 
peranuated apothecary cubs, broken merchants, some tourists, chroniclers of marvel- 
ous events, &c. 

These fellows sell all sorts of secret remedies, plasters, pills, powders, &c. They 
expose their merchandize in public places, in the temples and streets, and endeavor 
by fine speeches to extort money from the passers by. Some, inventors of a plaster 
that cures all evils, have large colored pictures, with which they demonstrate the an- 
atomy of the human body. Others, practicing acupuncture, establish themselves at 
the crossings, blow in their instruments, arrange their stalls, and when a crowd col- 
lects, they announce that they are from such and such a province, or of such a family, 
that they are descendants of the celebrated acupuncturer, Li, and that they have at 
fast discovered that spot on the human body where bleeding can be practiced to the 
most advantage for the cure of all manner of diseases. 

The oculists arrange before them a little table where hang images of two enormous 
eyes, with the nomenclature of the diseases which may effect the organ of vision. — 
Many of their brother oculists prefer to adopt the proceeding of the celebrated oculist 
of their country who paraded at the fairs mounted on a black ass, the saddle of which 
served as a counter for displaying his drugs. The dentists are surrounded with tro- 
phies of their art; masses of extractedteeth, which are not always human. It is an 
odd thing that this latter class are noted for a complete taciturnity-^-the others are pro- 
digiously loquacious. — Trans, for Kentucky Medical Recorder. 



338 Eclectic and Summary Department. [July, 

'Remarks on Chinese Pharmacy. By Gustavus L. Simmons, of Sacramento, Califor- 
nia. — Having often read with interest, articles concerning the " State of Pharmacy" in 
other countries than our own, I have thought that a few observations I have been re- 
cently enabled to make in regard to the medical and pharmaceutical knowledge of 
the Chinese, might not prove uninteresting — especially as this ancient and singular 
race is at present attracting the attention of the civilized world. 

We have often read and heard that they had no regular system of medical practice, 
but depended for a cure, when sick, on incantations and superstitious orgies, similar 
to those practiced by many of the Indian tribes of North America. This idea we be- 
lieve to be untrue, as it is at total variance with our own observations. 

The city of Sacramento is the great interior depot for the Chinese in California. — 
Here a portion of the town is wholly occupied by them, in fact presents a miniature of 
a Chinese city, and as such is often visited by persons who desire to become better 
acquainted with the habits of this strange people. 

Hearing an apothecary was located there, I resolved to make him a visit, and ac- 
cordingly recently started on what I at first supposed would be a fruitless errand. — 
Fortunately, at the onset, I met with an intelligent Chinaman, who had been partially 
educated by the missionaries, and who could quite readily express himself in the En- 
glish language. 

This gentleman very kindly took upon himself the task of accompanying us, and ex- 
plaining all that became necessary. The exterior of the shop we visited was in no 
wise dissimilar to those of other occupations. A sign over the entrance alone, gives 
|the passer by a knowledge of the business followed within. 

The sign, in the present instance, must have cost the artist who executed it consid- 
erable labor. All of the complicated Chinese characters were deeply graven in the 
wood of which it was composed; gold and bright vermillion appeared in abundance; 
and a rich silk drapery, arranged in a tasteful manner, hid the edges from view. 

The inscription when translated read : " Tung Fuk Tung" and was the name of 
the " Teacher" with whom the proprietor of the shop had studied for a term of years. 

On entering we were struck with the absence of fluid preparations, and throughout 
our examination we discovered but one article of this kind, and not a single mineral 
preparation. 

A narrow but very high counter, a range of gaudily painted drawers, wide shelving, 
and sundry Cninese stools, constituted the shop furniture. The shelves were mainly 
occupied by bundles, containing roots, herbs, &c. ; and it will astonish many when 
they learn that we counted over eleven hundred bundles, each marked with a differ- 
ent character, and all brought from the Celestial Empire, thus proving that the " Ma- 
teria Medico 1 '' of the Chinese is in nowise deficient in the number of remedies. The 
drawers were divided into six compartments; unique porcelain "galley pots" occupied 
the shelving immediately over them; and above, ranged in regular order, were fancy 
packages, containing very diminutive bottles of strong ol. mentha piperita, and a pecu- 
liar kind of musk artificially manufactured. We also saw various compounds with 
long written papers attached, the true nature of which we were unable to determine, 
but from the remarks of our companion, we strongly suspected that even the " Celes- 
tials" were not free from the " cure alls" and " patent nostrums" which flourish so great- 
ly in the United^States. The mortars used in compounding, are composed of porce- 
lain and iron, the shape being somewhat different from those manufactured by the En- 
glish. 

For powdering, an exceedingly uncouth instrument is used. It is made of iron, 
about four feet long, and the inside resembling a whale boat with a depressed cen« 



1854.] Eclectic and Summary Department. 839 

ter and elevated ends. A heavy iron wheel hung on a wooden axis is made to re- 
volve in the channel, the motive power being the feet of the operator. This quickly and 
easily reduces most substances to a powder. 

Various sizes of knife blades arranged on the end of an elevated trough, in a similar 
manner to the old style of straw cutters are in use for cutting up roots and barks; also 
large shallow baskets for drying purposes. 

The scales show the great antiquity of the people. They still disdain to use other 
than those which have been in use for centuries. These have but a single plate and a 
long beam, the weight sliding on this last, similar to the old fashioned steelyard. Many 
however are of fine workmanship, and in the hands of a skilful person prove very 
accurate. 

For writing their prescriptions, labeling, and in fact for all kinds of writing, they use 
the camel's hair pencil and India ink* Each store has these laid on a small stone slab, 
and rice paper by the side for immediate use. 

We now come to the nature of the remedies given by Chinese physicians, for the 
cure of the sick. A Chinaman always prides himself on the ancient origin and un» 
changeableness of his people, and it is probable that but few articles have been added to 
their " Materia Medica" for many hundred years. Unfortunately, out of the nume- 
rous articles we examined, but very few were familiar, and the similitude of uses with 
our own, induced us to copy them. They were Panax; Mentha viridis; Mentha 
piperita; Cinnamomum ; Glycyrrhiza radix; Scilla ; Senega ; Ulmus cortex; Rheum ; 
Resina; Maranta ; Carbo ligni ; Ficus; Camphor; Moschus; Anthemis; Hordeum 
Aurantii cortex; Crocus; dried snakes, and dried flies. 

The Ulmus. Maranta and Hordeum, are used as articles of diet for the sick; the 
Cinnamomum, Aurantii cortex, Glycyrrhiza, &c, for flavoring and disguising medicines 
of a nauseous taste: Camphor as an aromatic, and decoctions of Senega and Scilla as 
expectorants, The dried snakes are only for external use in rheumatic pains, but tho 
dried flies, which greatly resemble the ' k Cantharis vesicatona" of the U, S. P. we were 
repeatedly assured were given in cases of gouorrhcea, and were considered in that dis- 
ease as a specific, thus proving their acquaintance with the diuretic properties of the 
article. 

Nearly all medicines are given in the form of a decoction, and each prescription 
usually contains from twelve to twenty articles. 

During sundry visits to our Chinese professional brother, we have seen him com- 
pounding, and we have never noticed less than twelve articles in any of the prescrip. 
tions he has compounded while we were present. 

Through his politeness, we were favored with a written recipe for fever and ague, 
which he compounded for us, and which presents a singular appearance to the Ame- 
rican eye. We have forwarded a portion to the editor of the American Journal of 
Pharmacy for inspection. — American Jotirnal of Pharmacy. 



The Fees of Physicians. — In this city, as in many other places, the. physicians 
have been discoursing lately, on the propriety of revising their fee-bills. In several 
places they have increased their charges all around; for what their fathers charged 
one dollar they propose to charge two. Here, while there seems to be a general in- 
clination to increase the rates of charge, there is much objection to binding themselves 
to a fixed tariff; and in the Academy of Medicine, the fee-bill has been put aside in- 
definitely. This course is not, however, by any means, an indication that they are 
satisfied with their old fees, or will decline to charge for services in proper ratio to the 
increased cost of living. The labourer gets two dollars where formerly he got one. 



340 Eclectic and Summary Department. [July, 1854.] 

The lawyer charges ten for what his father was satisfied to ask five for. The penny- 
a-liner now wants two pence for his item, and the preacher has a call in another di- 
rection, if they offer no more in his parish than was deemed ample for his predeces- 
sor. Why should the doctor, who works harder than any of them, and cannot collect 
half his dues, suffer an exception to the rule of advances in payment? 

But the dollar he charges now is only worth the half dollar his old partner charged. 
It gels only half as much flour, or half as much meat, and it takes twice as many of 
them to buy a coat as his old partner gave, Butchers will not make a deduction of 
fifty per cent, to physicians, nor will the grocer put his tea and coffee and smoked beef 
down at half price to, the regular M. D, Seeing, then, for all his necessaries and his 
luxuries, he must pay twice as much as his father paid, he should receive twice as 
large a bonus for the sleepless nights and doleful days that his tarrying by the sick 
man's bed makes the still chamber cheerful. 

But whiie the doctors are regulating their monetary matters, we would suggest 
one radical change. Let them forswear the credit system utterly, and make cash 
payments the rule. Other men do it, and do well by the policy. Your credit-giving 
merchants are always making men angry with their dunning letters. Your credit- 
giving grocers are the ones that are always in trouble about the bills they render, and 
whom you conclude are dishonest, because their account and your recollections can- 
not be made to agree. Giving credit in these small matters, is an old fogy custom, 
which deserves to be exploded before another New Year's Day. Then we never 
saw a sick man who did not believe his doctor cheap at any price, but when he gets 
well, his doctor is " a terrible fellow for a bill !" While the pain lasts, or as it first be- 
gins to abate, the dollar goes over to the good man who brought the assuaging 
draught as easy as for a drink or a dinner. But how it seems to be picked out from 
among the heart strings when the pain is forgotten ! "All that a man* hath will he 
give for his life" when he is in danger of losing it, but when he is well, he will palter 
and argue, and pinch a half eagle that is demanded as "its equivalent." 

The people are ripe for the change. Not all of them, indeed, for there are men 
who are great patrons of the doctor, who always move out of the city before it is con- 
venient to pay, and they would think it very small business to be paying for, every 
call when it is made . But "paying subscribers" always want to know the paper's 
price before subscribing, and dying patients would die easier with only one call for 
their executors to settle for; or, if that is their fate, convalesce more rapidly with no 
debt of indefinite size ahead, to eclipse their bright prospects. " Pay as you go," sick 
man, and you'll appreciate your doctor better, and prevent half his unnecessary calls. 
Let the doctor demand pay as he goes, and he will strive the harder to make his ser- 
vices valuable, save himself a world of annoyance, double his annual income, and 
have the pleasure of knowing when he is conferring eharity, and when working for 
hire. — N. Y. Daily Times. 



Aconite Liniment. — Macerate four ounces of powdered aconite root in half a pint 
of alcohol, for twenty-four hours: then pack it in a displacer, and add alcohol gradual- 
ly until a pint of tincture has passed. Distil oft" twelve fluid ounces, and evaporate the 
residue until it measures twevle fluid drachms. To "this add two fluid drachms each 
of alcohol and glycerin, and mix them. It is used as an external anaesthetic applica- 
tion in the following manner. Cut a piece of lint or muslin of the size and form of the 
part to be treated, lay it on a plate or waiter, and by means of a camel's hair brush 
saturate it with the liniment. Tins may be applied to the surface, with a piece of oiled 
silk laid over it, to prevent evaporation. It should not be applied to an abraded surface, 
and the patient should be cautioned in reference to its poisonous character. — Journal 
of ' Pharmavij, y 




EHTEmmnBYEB.WELCE./PBh i - imiMMRREOTIFll'EY JOfflTA WHIFFLE. BOSTON. 






O-ZK^MU/^ 




? 



/ 



IN THE UNIVERSITY OF ' % IN 

Pn~hl e 



THE 

NEW JERSEY MEDICAL REPORTER, 

VOL. VII. AUGUST, 1854. NO. VIIL 

AMERICAN MEDICAL ASSOCIATION. 



History of the American Medical Association, 



NUMBER V. 



BY ONE OF ITS MEMBERS. 



Nothing of special interest occurred in relation to the American Me- 
dical Association, from the close of the Annual Meeting in Baltimore, 
until the commencement of the second Anniversary in Boston, May 1, 
1849. The minutes of the meeting in Baltimore, were very generally pub- 
lished in the Medical Journals of the country ; and the work of organ- 
izing state and local Societies, as mentioned in our last number, contin- 
ued to progress. 

On the first day of Ma$, 1849, the delegates and members assembled 
in the Hall of the Lowell Institute, and at 10 o'clock, A. M. were called 
to order by Dr. Alexander H. Stevens, of New York, President of the 
Association. Dr. J. C. Warren, of Boston, in ,behalf of the Massachu- 
setts Medical Society, and the Committee of arrangements, welcomed 
the delegates to their city, and extended to them the cordial greeting of 
the profession. The President then delivered an address, in which he 
alluded to the objects for Which the Association was organized, and the 
important advantages expected to result from its action. More than four 
hundred members were present during the meeting, representing the 
profession and institutions of twenty-four States. 

On the recommendation of a Committee of one from each state re- 
44 



342 Original Communications, [August, 

presented, the following gentlemen were elected officers of the Associa- 
tion, viz : 

PRESIDENT. 

Dr. J. C. Warren, of Boston. 
VICE-PRESIDENTS. 

Drs. J. P. Harrison, of Cincinnati ; A. Flint, of Buffalo; H. H. 

Maguire, of Richmond ; R. S. Stewart, of Baltimore. 
SECRETARIES. 

Drs. A. Stille', of Philadelphia; H. Y. Bowditch, of Boston. 

TREASURER. 
Dr. Isaac Hays, of Philadelphia, 

Dr. Warren, on being conducted to the Chair, returned his thanks to 
the Association for the honor conferred, after which the reports of the 
Standing Committees were called for, and presented in order. Dr. D. 
F. Condie, Chairman of the Committee on Practical Medicine, present- 
ed a lengthy report ; only a part of which was read, when on motion of 
Dr. A. H. Stevens, it was referred to the Committee of Publication. 
This was the beginning of a policy, which has resulted in the establish- 
ment of the practice of receiving and referring papers to the Publishing 
Committee, not only without being read to the Association, but without 
having been completed by their authors. 

Dr. N. R. Smith, of Baltimore, Chairman of the Standing Commit- 
tee on Surgery, read the annual report on that subject. 

The consideration of anaesthetic agents, the treatment of fractures, 
and the operations for vesical calculi, occupied much the larger snare of 
the report. The committee fully justified the us6 of anaesthetics in all 
important surgical operations, and gave preference to chloroform, over 
ether. 

The report of the Committee on Obstetrics was presented and read by 
Dr. C. R. Gilnian, of New York, acting Chairman, 'this report was 
also occupied chiefly with the consideration of anaesthetics, and their 
application in Obstetric practice. It was claimed by the author of this 
report, that the use of tliese agents was not only justifiable for the pur- 
pose of alleviating the pains of labour, but also, that in all difficult and 
instrumental labors,, their application " could not be rightfully tvitJihekl." 
This report also, gave the preference to ehloroform over all other anaes- 
thetic agents. This, like the report on Surgery, was referred to the 
Committee, on Publication, without discussion. They were published in 
the second volume of Transactions of the Association, and may be use- 
fully consulted, both by students and practitioners of the healing art. 

Dr. J, P, Harrison, of Cincinnati, Chairman of the Committee ow » 



1854.] American Medical Association. 343 

Medical Literature, presented and read, a full and well written report ; 
which was referred to the Committee on Publication. 

The Committee claimed that much valuable literary material existed 
in the profession of our country, which was unknown to the public, on 
account of the inability of the authors to procure its publication. And 
they recommended the establishment of a Board of Publication, to 
whom such materials might be presented for examination and publica- 
tion, if approved by them. The following resolution, appended to the 
report on Medical Literature, was adopted by the Association, and Drs. 
W. E. Horner, D. F. Condie, and Isaac Hays, of Philadelphia, appoint- 
ed the Committee, viz : 

" Resolved, That a Committee of three be appointed, to take into con- 
sideration the measures recommended in this report, for the promotion 
of our National Medical Literature, with instructions to report at the 
next Annual Meeting/' 

On motion of Dr. Gr. B. Wood, the same Special Committee were in- 
structed to report on an international copy-right law. 

At a subsequent part of the session, Dr. Horner, in behalf of the 
committee, reported the following resolution. 

" Resolved, That a committee of three be appointed to memoralize 
Congress in favor of an international copy-right law." 

The resolution was adopted, and Drs. Gr. B. Wood, T. E. Bond, and 
Isaac Hays, appointed the committee, with instructions to prepare a 
memorial, and submit it to the next Annual Meeting of the Association. 
At this, as at all the preceding meetings of the Association, the subject 
of Medical Education occupied a large share of time and attention. Dr. 
F. Campbell Stewart, of New York, Chairman of the Standing Commit- 
tee on Medical Education, presented a full report, embracing an account 
of the medical institutions, requirements for graduation, number of stu~ 
dents and Professors, &c. &c, both in this country and Europe; also, 
an account of the legal requirements exacted of medical practitioners in 
the several states, and the rules and requirements of the Army and 
Navy Boards of Examiners. 

The report urged strongly, the adoption of a higher standard of pre^ 
liminary education, to be exacted before allowing the student to enter 
upon the study of medicine, as the basis of all real improvement in the 
education of the profession. To secure this, alj. state and local societies 
were recommended to establish primary Boards of examiners, whose 
duty it should be to examine all who proposed to study medicine within 
their respective districts, except such as were graduates of some literary 
institution, and grant to those qualified, certificates of such qualifica- 



344 Original Communications. [August, 

tions. A series of resolutions were appended to the report, designed to 
elicit direct action on the part of the Association. 
They were as follows, viz : 

1. "Resolved, That the attention of Medical Colleges be again di- 
rected to the resolutions of the Committee on Preliminary Education, 
adopted by the Medical Convention of 1847, and that they be advised 
to require from students that they shall, in all cases, produce certificates 
of Preliminary Education. 

2. " Resolved, That the several State and County Societies, as well 
as all voluntary Medical Associations, throughout the country, be advi- 
sed and requested to adopt the plan proposed by the Medical Society of 
the State of New York, at its last Annual Meeting, for ensuring due at- 
tention to the subject of preliminary education. 

3. "Resolved, That this Association does not sanction or recognize 
" College Clinics" as substitutes for Hospital clinical instruction, and 
that the Medical Colleges be again advised to insist, in all instances 
where it is practicable, on the regular attendance of their pupils during 
a period of at least six months,upon tl}e treatment of patients in a well 
conducted Hospital, or other suitable institution, devoted to the recep- 
tion and care of the sick. 

4. " Resolved, That it would conduce both to the convenience and 
advantage of students, if the subjects taught in the Colleges were divi- 
ded into two series ; the one of which should be studied during the 
first year's attendance on lectures, and the other during the second ses- 
sion. And £hat examinations should be instituted at the close of the 
first course of lectures on the subjects taught during that course ; certi- 
ficates of which should be required prior to the final examination. 

5. u Resolved, That it is ihe deliberate opinion of this Association, 
that the plan of examining students for medical degrees in private, and 
before one Professor only at a time, is highly defective, and should be 
at once discontinued. 

6. "Resolved, That examinations for medical degrees shoulol be 
practical, and that it is desirable, as far as practicable, that they should 
be conducted in writing as well as viva voce. 

, 7. " Resolved, That in view of the importance of a due knowledge 
of practical Pharmacy, the Medical Schools be advised to require from 
candidates for degrees, that they should produce satisfactory evidence of 
having been engaged in compounding medicines and putting up pre- 
scriptions, either under the directions of their private preceptors, or in 
the shop of a recognized and qualified apothecary. 

8. " Resolved, That the interests, both of the public and the Medi- 
cal profession, would be promoted by the establishment of Boards of ex- 
aminers in each of the States of the Union, to examine candidates for 
licenses to engage in the active practice of Medicine and Surgery. 

9. " Resolved, That the standard of requirements established by the 
examining Boards of the several States, should be uniform, and that 
the examinations should, as far as practicable, be conducted in a similar 
manner. ., 



1854.] American Medical Association. 345 

10. " Resolved, That the examiners should, in all instances, satisfy 
themselves, that candidates are familiar with the elementary branches 
of general knowledge. 

11. "Resolved, That for the purpose of carrying out the objects con- 
templated in the foregoing resolutions, a Special Committee of seven 
members be appointed to prepare a memorial and form of law in refer- 
ence to the subject of the establishment of Boards of Medical Examiners, 
to be submitted to the Association at its next Annual meeting." 

The report of the Committee on Medical Education was accepted, 
and referred to the Committee on Publication, and the resolutions taken 
up for action thereon. 

In this connection a communication was received from the New York 
Academy of Medicine, in the form of a series of resolutions, which had 
been adopted by that body. The resolutions advocated a higher stand- 
ard of preliminary education, and a separation of the business of teach- 
ing and licensing, hitherto united in the College Faculties. This com- 
munication, together with a letter from Dr. John Watson, of New 
York, were received and laid on the table. 

The resolutions of the Committee on Medical Education, were 
discussed at ponsiderable length, in committee of the whole, and 
those numbered 1 and 3 adopted, and the rest either amended, 
rejected, or laid on the table. The Committee then rose and 
reported, when on motion of Dr. Alexander H. Stevens, the whole 
subject of Medical Education, together with the resolutions just 
acted upon in Committee, were referred to a Special Committee of 
three, with instructions to report the next morning. The President ap- 
pointed Drs. A. H. Stevens, GL B. Wood, and J. Knight, the Commit- 
tee. The communication from the Academy of Medicine, and the letter 
of Dr. Watson, were * taken from the table and referred to the same 
Committee. 

Dr. Stevens in behalf of the Committee, reported back the 1st and 3d 
resolutions, already quoted, without alteration, and in addition the fol- 
lowing: 

"Resolved, That the Association reiterate their approval of the reso- 
lutions in reference to Medical Education adopted by the Convention, 
which met in Philadelphia, in May 1847, and contained in pages 73 
and 74 of the published proceedings of that Convention. 

"Resolved, That physicians generally, throughout the Union, be ad- 
vised and requested, to require of those wishing to become their pupils, 
evidence of a proper general education, before admission into their 
offices. 

" Resolved, That in accordance with a resolution of the American 
Medical Association, adopted May 4, 1847, it is earnestly recommended 
to the physicians of those states in which State Medical Societies do not 



346 Original Communications. [August, 

exist, that they take measures to organize them before the next meeting 
of this Association. 

" Resolved, That the State Societies be recommended, after they shall 
have been organized, to recognize as regular practitioners, none who 
have not obtained a degree in medicine, or a license from some regular 
Medical body, obtained after due examination. 

" Resolved, That the Association recommend to the various Schools 
of Medicine, to meet at Cincinnati before the next Annual Meeting of 
this Association." 

After much discussion, these resolutions were all adopted, together 
with the following, which was offered by Dr. T. E. Bond, of Baltimore, 
viz : 

" Resolved, That this Association recommend the encouragement of 
private Medical Institutions, strongly advising that Dispensary Practice 
be made, as far as possible, a part of the means of instruction/' 

In connection with the report of the Committee on Medical Educa- 
tion, Dr. Ware, of Boston, presented a paper from the Faculty of Har- 
vard University, against the proposition to extend the annual College 
terms to six months. This communication having been received and re- 
ferred to the Committee on Publication, on motion of Dr. Gr. B. Wood, 
a Committee of three were appointed to write and present to the Com- 
mittee on Publication, a paper, setting forth the views of the Associa- 
tion in favor of a lengthened term. The President appointed Dr. Sam- 
uel Jackson, of Pennsylvania University, Dr. J. L. Atlee, and Dr. A. 
Stille, of Philadelphia, the Committee. 

This Committee discharged the duty assigned to it, and both papers 
may be found in the volume of Transactions for 1849. 

Besides the reports of Standing Committees already noticed, Dr. L. P. 
Yandell, of Kentucky, Chairman of the Committee on Medical Sciences, 
forwarded his report, which, in his absence, was referred to the Pub- 
lishing Committee without being read. 

The annual report of the Committee on Hygiene, was presented and 
read by Dr. Isaac Parrish, of Philadelphia. It embodied much valua- 
ble information in relation to the Sanitary statistics and condition of the 
more important cities of our country; and had appended, a very lengthy 
and important report on the sanitary condition of Massachusetts, by Dr. 
Josiah Curtis, of Boston. 

The annual report of the Committee on our Indigenous Medical Bota- 
'ny, &c, was presented by the Chairman, Dr. N. S. Davis, with two 
papers appended, in the form of Botanical Catalogues of Medicinal 
Plants, one by Dr. S. W. Williams, of Massachusetts, and the other by 
Dr. F. P. Porcher, of South, Carolina. All these, together with an, ip- 



1854.] American Medical Association, 347 

teresting paper from Dr. Samuel Jackson of Philadelphia, on the effects 
of tea and coffee on children and the laboring classes, were referred to 
the Committee on Publications, and may be found in the Transactions of 
that year. 

On motion of Dr. A. H. Stevens, of New York, three additional 
Committees were instituted, viz : A Committee of seven, on Forensic 
Medicine ; one of like number on Indigenous Botany and Materia Medi- 
ca; and another on Public Hygiene. 

These, together with the former Standing Committees, were filled for 
the coming year, by the Committee on Nominations. 

It will be seen, both from the number of States represented, and the 
whole number of delegates in attendance, that the meeting of the Asso- 
ciation in Boston, presented a very full representation of the Medicat 
profession of this country, not only as a whole, but also in its several 
departments and special interests. Hence, its action may be justly 
claimed as a fair expression of the sentiments of the great body of the 
profession. It was in view of this fact, that I quoted in detail the reso- 
lutions presented and adopted, concerning the all engrossing subject of 
Medical Education and improvement. In former numbers of this history, 
I have shown that this subject was the leading one which called forth the 
movement that resulted in the formation of the Association itself. And 
further, that in direct connection with the act of organization, the most 
decided stand was taken in favor of elevating the standard of attain- 
ments, both preliminary and medical; of extending the lecture terms in 
the several Colleges ; of making practical Anatomy and Clinical in- 
struction, essential elements in a course of medical study ; and of ex- 
tending and completing the social organization of the profession, 
throughout the Union. It will be seen by the resolutions adopted and 
quoted in this number, that the meeting at Boston fully sanctioned and 
confirmed the action of the primary Conventions in New York and Phi- 
ladelphia, in reference to all these topics. That the profession demands a 
higher standard of general education on the part of students of Medi- 
cine, a more systematic and complete course of instruction on the part 
of the Medical Colleges, and a more rigid and disinterested examination 
of candidates for graduation, there can be no doubt. 

The resolutions adopted at Boston and elsewhere, abundantly indicate 
this. And yet, five years have passed away without the full accom- 
plishment of any one of these objects. There are two prominent rea- 
sons for this failure. The first, consists in a disposition to look to the 
Medical Colleges for too large a share of the action necessary for the 
accomplishment of the objects desired, 



S4S Original Communications. [August, 

Instead of regarding these institutions as mere schools for Medical in- 
struction, and demanding of them such action only, as was calculated to 
render their courses of instruction more systematic and complete, they 
have been looked to for the practical execution of almost every specific 
recommendation which has been made by the Association on the sub- 
ject of education. Thus, of the seven resolutions adopted at Boston, as 
reported by the Special Committee, of which Dr. Stevens was Chairman, 
four related directly to the action of the Medical Colleges, two to the 
further organization and action of State Medical Societies, and one, 
couched in very general terms, was addressed to the individual members 
of the profession generally. The disposition to which I refer is well 
illustrated by the action taken in reference to preliminary education. 
The Convention at Philadelphia had declared the necessity of a more 
elevated standard of preliminary acquirements, but had pointed out no 
special mode for securing its adoption in practice. To supply this defect, 
one of the County Medical Societies in New York, (I think the Erie 
County Society, assembled at Buffalo,) appointed a Board of Censors, 
and made it the duty of all members to require of young men applying 
for admission into their offices as students of medicine, to bring a certi- 
ficate from said Board, that they possessed the requisite preliminary 
education. The same measure was brought before the New York State 
Medical Society, at its next annual meeting, and resolutions were adopt- 
ed, requiring all its members to demand of students, before admission 
into their offices, either a regular diploma from some established Litera- 
ry Institution, or a certificate from a Board of Censors, that they pos- 
sessed at least the amount of general knowledge set forth in the stan- 
dard of preliminary attainments, adopted by the National Convention of 
1847 ; and also, recommending all the County Societies in that State to 
appoint Boards of Censors for that purpose. It will be seen that the 
Standing Committee on Medical Education, which reported to the meet- 
ing of the Association, in Boston, fully endorsed this plan, and in their 
second resolution^ already quoted, recommended it for adoption by all 
the State, County, and voluntary Medical Associations throughout the 
whole country. This was a specific plan, fully within the control of 
the local profession everywhere, eminently practical in its nature, and 
well calculated to secure the end proposed ; and' yet, the Association 
after adopting a resolution strongly advising the Medical Colleges u to 
require from students, that they shall, in all cases, produce certificates of 
preliminary education," rejected this plan, andin its place adopted the 
very general and vague recommendation, <c that physicians generally, 



1854.] American Medical Association, • 349 

throughout the Union, be advised and requested to require of those 
wishing to become their pupils, evidence of a proper general education, 
before admission into their offices/' By such action, the Association 
directly refused' to provide or recommend any regular mode, by which 
the student was to procure the very certificate, which the Medical Col- 
leges were advised to require of him. Of course, the latter have paid 
no heed to the advice, and the subject of preliminary education remains 
very nearly where it was before the Association was organized, at least 
-so far as regards the adoption of any general or uniform standard. If 
it was the general practice for students to commence their studies by 
enrolling their names on the matriculation book of some Medical Col- 
lege, and attending a Course of Lectures on the more elementary 
branches, such as Anatomy, Chemistry, Physiology, &c, then there 
would be propriety in requesting the Colleges to require, in all cases, a 
certificate of proper preliminary education. But it is well known that 
nine-tenths of all the students, first enter the office of some practitioner, 
and there pursue their studies from six months to two years, before they 
attend any Medical College. "When they come to the College, they 
bring to the Faculty letters of introduction from their preceptors, set- 
ting forth that they have studied a certain length of time, and possess 
good moral characters. Suppose it is soon ascertained that one half of them 
are sadly deficient in their general education ) a second look at their let- 
ters of introduction and certificates of study, will show that their pre- 
ceptors are members of the State Medieval Society, in good standing, 
and not unfrequently, even members of the American Medical Associa- 
tion. Now, is it reasonable to suppose that the Colleges will ever go 
back of the private preceptors, and take the responsibility of shutting 
such students out of their Halls ? Certainly not. But they will con- 
tinue, as they have done, to claim that the responsibility of exacting 
proper preliminary education is with the profession at large, and that 
the place to demand evidence of it, is at the door of the office in which 
the pupil proposes to commence his studies. In this, the Colleges are 
right, and the sooner the members of the profession can be made to feel 
their individual responsibility in the matter, the better for all parties, 
And this leads directly to what we deem the second great cause of fail- 
ure in our efforts to improve the education and usefulness of the profes- 
sion, viz : the absence of a due sense of individual responsibility, and of 
a willingness to act up thereto, on the part of the great mass of medical 
practitioners. 
45 



350 Original Communications, [August, 

It is a very easy matter for men to assemble in Conventions and So- 
cieties, and declare abstract truths in formal resolutions. 

For instance, nothing is more easy than for anti-Slavery men to meet 
and resolve that slavery is a great moral, social, and political evil. But 
to devise a practicable mode of doing it away, which shall be just to all 
parties, is a task defying the profoundest intellect, and the purest phi- 
lanthropy. 

So to, it is very easy for medical men to meet and declare in formal 
resolves, that the standard of education, both preliminary and medical,, 
is too low— that the Colleges ought to require this and that. But so 
long as they not only feel no individual responsibility in the matter, 
but return to their homes and send directly from their own offices, young 
men to the Colleges, who are grossly deficient in almost all the element- 
ary branches of knowledge, they must not only expect to see their re- 
solves unheeded, but they need feel no surprise if some wanton critic 
should liken them to the Lawyers of old, who were accused of "binding 
heavy burdens and placing them on other mens' shoulders, while they, 
themselves, would not so much as touch them with one of their fingers.'* 
We have no apologies to offer for the many delinquencies of the Col- 
leges ; but all the defects of the profession are, by no means, attributa- 
ble to them. Neither can they be all removed by any action of these 
institutions. To effect this, the profession at large, and in their indi- 
vidual capacity, must, not only resolve, but act ; and that too, under a 
proper sense of personal responsibility and influence. 



Albuminuria ; Congestion and Hypertrophy of Kidneys : Bright *s 
Disease: Fatty Degeneration. By John H. Griscom, M. D., of 
New York. 

The investigation and development of the branch of medicine indica- 
ted by the above terms, afford one of the most gratifying instances of 
the advance of modern pathology : fresh fields of observation are opened 
to us, and we are supplied with new and most valuable means of arri- 
ving at correct diagnosis, in a class of ailments, which, though of high- 
ly important character, and by no means infrequent, have, until very re- 
cently, been almost a terra incognita. The elaborate investigations and 
fertile results of the labors of Blight, Prout, Christison, and numbers 
of others, including several able pathologists in our own country, in this 



1854.] Griscom — Diagnosis of Renal Diseases. 351 

line of observation, have gone far to settle the question of the true na- 
ture and frequency of renal disorders, and direct us the mode of their 
examination. 

It is not my intention, and it would be presumptuous in me, after their 
elaborate publications, to attempt an Essay on these diseases. My ob- 
ject in this paper is simply to offer some remarks on the subject of Al- 
buminuria, especially in relation to its true value as a diagnostic symp- 
tom in diseases of the kidneys, together with a criticism upon the pro- 
priety of the use of the term as it is now commonly employed ; what 
I have to say being founded chiefly on the observation of a few cases of 
renal disorder, which came under my care during my attendance at the 
New York Hospital, in the first three months of the present year. 

The term u Albuminuria/' has of late come into very common use as 
the cognomen of a disease, or some one of a class of diseases, recently 
found to be of frequent occurrence. When, some years ago, this branch 
of medical inquiry was first presented to the notice of the general prac- 
titioner, the fact of the existence of albumen in the urine, was believed 
by many to be the disease which was to be treated, — that it was depen- 
dent upon some functional disturbance of the kidneys, whereby in some 
obscure way this substance was eliminated from the blood, or generated 
de novo, by the secerning vessels, and deposited in the urinary current. 
To counteract this tendency to its formation, was for a time, the chief 
object aimed at in the treatment ) and if successful in this, the disease 
was believed to have been removed. Hence the class of remedies which, 
under this view, were indicated, consisted of those which were presumed 
to have the power to neutralize, so to speak, the supposed subverted 
chemical influence, which resulted in the elimination of the albumen. 
It was, however, soon seen that this was a very unphilosophical view of 
the symptom, and although the precise mode in which the albumen 
finds its way into the urine, is yet unsettled, and the nature of its con- 
nection with the nephritic disorder is unexplained, yet it is of much 
value as a finger, to point to the most probable source of the patient's 
disturbance of health. 

The employment of the word as a diagnostic term, is therefore erro- 
neous ; it does not partake of the accuracy which should always, as far 
as possible, characterize medical language. It represents rather a symp- 
tom than a disease. Albuminuria means simply albumen in the urine, 
and is derived from the mere fact that on the application of nitric acid, 
heat, or other proper reagent, to the urine of the patient, albumen is 
coagulated, and is precipitated in greater or less quantity But the im- 



352 Original Communications. [August, 

mediate source of this stranger, in this secretion, is not explained by the 
term. That it is ultimately derived from the serum of the blood, may 
be readily supposed, but whether it finds its way with the urine through 
the kidneys, (and if so, whether by a physical or pathalogical process,) 
or whether it is deposited in the bladder from the circulating vessels of 
that viscus, and there mingles with the urine previously deposited from 
the ureters, are questions upon which sufficient light has not been shed. 
Certain it is however, that albuminous urine is not a pathognomonic symp- 
tom of asy disease, as the cases I shall give will show, much less can it 
be called a disease itself. With equal propriety might anasarca be de- 
nominated a disease, when we know it to be only the result of some dis* 
order not indicated by the name. To determine the true value of albu- 
minuria as a symptom^ it must be compared with others, and such 
weight only be given to it, as it may be found, corroborative of them. 
Alone, it leads to uncertain and even contradictory conclusions. It is 
common to more than one disorder, diverse both in nature and indica- 
tions of treatment. 

This is exemplified by the two following cases of nephritic disease, 
which present some points of similitude, especially that of urine deficient 
in quantity and copiously albuminous, but which differ widely in their real 
nature. 

Case 1. Harriet Savage, set. 16, single, admitted into the Hospital, 
March 2d. About two months before, she perceived the commence- 
ment of general anasarca. She had not been previously sick, had had 
no pain in the lumbar region, nor any trouble in chest or abdomen. She 
had never menstruated. When admitted, the whole body was enor- 
mously bloated, especially the face and neck, which were cedematous to 
a remarkable degree, giving her the appearance of a very fat old woman. 
She could speak with very great difficulty, and her respiration was ac- 
companied with gurgling, referrible to oedema of the glottis and posterior 
fauces. Is now very deaf. Urine very scanty, not a half pint in 12 
hours, and deposits albumen abundantly, by heat and nitric acid. Sp : 
Gr : 1018. Patient very much exhausted by the fatigue of removal, 
and threatened with suffocation from the accumulation of fluid in the 
lungs, and about the air passages. Diaphoretics and counter irritants 
were the only admissible means of treatment, under which she improved 
a little, for two days. The improvement was however, but temporary, 
as four days after admission she died, literally drowned in her own 
fluids. 

The autopsy revealed enormous effusions into the cavities of the chpst 



1854.] Griscom — Diagnosis of Renal Diseases. 353 

and abdomen, as well as into the subcutaneous cellular tissue, which 
latter presented, under the knife, exactly the appearance of a fresh cut, 
very juicy, orange. The organs generally were exsanguineous, except 
the liver, which exhibited very considerable congestion of the portal 
system. The kidneys were greatly hypertrophied, weighing, one, eight 
ounces, and the other ten ounces, but no traces of fatty deposit were dis- 
cernible. 

Case 2. G-eorge Saffler, set. 25, seaman, was brought in, March 25, 
at 11 o'clock, P. M., by the Police, who found him lying in the street. 
He was apparently drunk when admitted. Kespiration labored, sighing, 
pulse eighty, full -, skin warmer than natural, dry ; could only tell his 
name and birth-place ; pupils natural, eyes rolled up ; apparently, there 
was entire suppression of urine; he passed none after admission. A 
very little was drawn off by the catheter, tested with nit: acid, and 
found to be almost wholly albumen. Sp. Gr. 1012. The next day he 
was entirely comatose ; pupils insensible. Tracheal rale ) feet and face 
(edematous. Fifty hours after admission, he died. 

The autopsy showed both kidneys enormously enlarged, weighing 
each, 16 ounces, pale, hard, with the tubular structure much encroach- 
ed upon by the cortical portion, which ivas abundantly studded vrith 
fatty granular masses, presenting a rarely perfect specimen of this pecu- 
liar degeneration. 

The kidneys in these two cases, presented two very diverse conditions 
of disease, one being, and the other not being, in a state of fatty disor- 
ganization, yet the urine in both cases, yielded albumen abundantly. 
Much other testimony might be adduced both from books and unreport- 
ed eases, to show the non-reliability of this symptom in the diagnosis, 
and of course in the treatment of nephritic diseases ; as for example, 
the observation of Drs. Christison and Carrigan, that the presence of 
albumen in the urine was not in itself a proof of organic lesion ; — and 
it has even been remarked by Dr. Prout, that the re-appearance of albu- 
men in the urine, was a favorable symptom; — but it is unnecessary to 
enlarge proofs on this point. 

The tendency to, or the existence of, a deposition of fat in the secre- 
ting cells, and in the uriniferous tubes, though a very distinct disorder 
from congestion or inflammation of the kidneys, both are of very serious 
moment, call for very different treatment, and may afford very different 
prognosis from each other ; one being an organic, the other rather a 
functional disorder. 

On the other hand, the kidneys are sometimes found greatly diseased, 



354 Original Communications. [August, 

without the presence of albumen in the urine. Cases of granular de- 
generation in a marked degree, are sometimes observed, without any 
trace of albumen before death, even where the body was highly anasar- 
cous, and serous effusion in every large cavity oppressed the patient. 

The result therefore is, that this test, so easily made, and apparently 
at first sight, so very conclusive of organic or functional disturbance of 
the secreting organs, cannot be relied on as a pathognomonic sign; that 
its evidence must be corroborated by other testimony, in order to enable 
us to arrive at a correct diagnosis. 

To obtain this further testimony for the establishment of a correct di- 
agnosis, the microscope affords the only means at present known to us. 
There are indeed various other tests of the changes which from time to 
time occur in the chemical composition of the urine, but in the field of 
this instrument only, can be obtained the evidence which is to settle 
the question of the true pathological state of the urinary organs. What 
the relative appearances are under this test, of the different states of dis- 
ease to which these organs are subject, it is not my intention here to 
state ; it would be at best but an imperfect recapitulation of them from 
the able authors whose works are, or should be, found in every Medical 
Library. The microscope, moreover, is not accessible to the great mass 
of practitioners, especially to those in country ridings. In cities they 
are to be found in several public institutions, as well as in the hands of 
private practitioners, and may be readily consulted. 

Inasmuch, however, as, except the microscope, we have as yet no re- 
liable means for the detection of the peculiar substances, especially the 
fatty particles, which constitute the chief indications of difference be- 
tween the various renal diseases, it is to be hoped that the attention of' 
ingenious men will be directed to the subject of some more accessible 
method of distinguishing them. 

In the mean time, and in the absence of more definite resources, a 
ray of diagnostic light may perhaps be extracted from the progress of 
the case while under treatment, especially in its early stages. 

It will be remembered that the principal object is to determine whe- 
ther the disease of the kidneys, in the case before us, is functional, or 
structural ; whether it is a simple congestion, or inflammation, or a 
physical disorganization ; whether it is a case of fatty degeneration, or 
not. The microscope, by revealing the physical products of the dis- 
eased action, will most certainly determine the question. But in the in- 
accessibility of this test, have we any other source of light ? 

So far as I have observed these cases, there appears to be a result p£ 



1854.] GrRiscoM — Diagnosis of Jxenal Diseases, 6bD 

treatment, which, though subject of course to variation, presents some 
degree of uniformity, from which a diagnostic inference may be drawn. 
Thus it has been observed, that in one portion of the cases in which 
the presence of albuminous urine seemed to indicate the existence of 
nephritic disorder, the influence of treatment in increasing the amount 
of urine was generally much more prompt and decided than in the 
others. It will readily be inferred, that these are the cases in which 
the kidneys are functionally rather than organically deranged. Though 
the general condition of the patient may be very similar, in most re- 
spects, both presenting anasarca, deficient urine, mostly freedom from 
local pain, more or less dyspnoea, &c. and the general indications for 
treatment, also much alike, yet it is found that one class of these cases, 
the simple inflammatory or congestive, in distinction from those of the 
fatty disorganization, far more readily respond to efforts to re-open the 
closed secretions, than do the others. The two following cases will 
illustrate this point. 

Case 3. Carl Luckner, seaman, admitted, Feb. 28. One year ago, 
while in the West Indies, he first noticed some pumness about the neck, 
near the parotid gland, and under the lower jaw, which spread down- 
ward over the surface of the body. He was relieved in a Hospital at 
Hamburgh, and well for about six months. Three days before admis- 
sion into the New York Hospital, he was again attacked in a similar 
manner. He has never noticed any affection of heart, lungs, liver, or 
kidneys. There is no general oedema. The quantity of urine on ad- 
mission was small, with an acid reaction. Sp : Gr : 1018, albumen 250 : 
1000. The patient's general condition is good, — he is strong and rud- 
dy. A microscopic examination of the urine developed only lithic acid 
crystals in abundance, no fatty matter being discernible. He was treat- 
ed for the first fortnight with diaphoretics and diuretics, consisting chief- 
ly of the vapor bath ; Spts: Minder:, and infusion of Diosm:, Cren: with 
no improvement in the quantity of urine, until he was bled to the ex- 
tent of 8 or 10 ounces, about a fortnight after admission, when the 
quantity rose in three days from less than one pint to two pints and three 
quarters pints, and in the course of the next fortnight, to six and three 
quarter in 24 hours. The oedematous effusion diminished, and the 
patient soon left his bed. 

Case 4. P. A. F. set 53, admitted, Feb. 20. One week previously 
complained of pain in the epigastrium, slight soreness of throat, and im- 
mediately noticed oedema of face and feet. No febrile excitement ac- 
companied these symptoms. He attributed the attack to cold and over 



356 Original Communications. , [August, 

exertion in nursing a relative for several weeks, under arduous circum- 
stances. Gave up work three days ago. On admission find the pulse 
natural, skin moist and warm ; oedema of the feet, face, and abdomen ; 
cough and dyspnoea, with sonorous ronchus over the chest, and mucus 
rale at base of both lungs ; countenance pale ; urine of fair color, one 
pint and a half in 24 hours, with free albuminous reaction by heat and 
nitric acid — Sp: Gr: 1013. No cardiac complication, nor hepatic dis- 
turbance, appetite fair. Under the usual course of diuretic and diaphor 
retic treatment, aided by an occasional hydrogogue cathartic, the pa- 
tient's general condition improved considerably — the cedema subsided 
somewhat, though it never disappeared, but the quantity of urine void- 
ed in 24 hours, could not be raised above two and a half pints at any 
time, and was rarely over two pints. Its microscopic examination de- 
veloped cells containing fat in abundant quantity,, with casts of urinife- 
rous tubes, and blood corpuscules. As the cedema of the external cellu- 
lar tissue subsided, oedema of the lungs supervened in a more decided 
degree, complicated at last with pneumonia, under which he sank 
comatose, 40 days after admission, having passed no urine at all, in the 
last 36 hours of his life. 

The noticeable points in these two cases, in contrast with each other, 
were first, the absence, under the microscope, af any trace of fatty mat- 
ter, or other disorganized substance, in the one case, and their abundant 
appearance in the other ; and secondly, the ready restoration of the se- 
creting power of the kidneys in the one case, and its failure in the other. 
My argument assumes that there is a more or less intimate relation be- 
tween the pathological condition of the kidneys, and the result of the 
treatment, in both cases, and that from its success in the one, and its 
failure in the other, an inference may be drawn of the organic or inor- 
ganic nature of the disorder. This idea is not based upon the observa- 
tion of these two cases alone, (which are presented as illustrations mere- 
ly,) though it is, confessedly, upon an extent of observation, insufficient 
for a settlement of the question. Nor, indeed, could this rule, though 
based upon a very general observation, be expected to be uniform, for 
though in cases of fatty degeneration, the restoration of the secreting 
power can never be reasonably expected; in many cases of the other 
class of disorders, the derangement may have proceeded to such a height 
as to render the difficulty insurmountable. In such cases, the suggest- 
ed diagnostic observation must fail, though it will generally render the 
prognosis more certain. But upon a -prima facise consideration, a resto-* 
ration of the secreting function would seem far more likely in a case of 



1854,1 Hunton — Indigenous Medical Plants. 357 

mere congestion or inflammation, or even hypertrophy of the kidneys, 
than in one of granular degeneration. I submit thought for 
what it may be worth, desiring only to lend a little aid in the develop- 
ment of this new but highly interesting field of study and practice, and 
in the hope that others may either confirm or disprove its value, as facta 
may warrant. 



Observations on the medical virtues of some of the most 'prominent Indi- 
genous Vegetables grown in Vermont. 
By Ariel Hunton, M. D. 

NUMBER III. 

NARCOTICS. 

Solanum Nigrum, — American Nightshade. This article is an annual 
plant, by some classed among the exotics, but I think it is a native. The 
stem is branched, glabrous, leaves ovate, berries abundant, and black 
when ripe ; has the rank narcotic odor, placed in the fifth class in Bota- 
ny, which contains many narcotic, or poisonous plants. 

I use this plant solely in the bone ointment , we have male and fe- 
male Cancer Doctors, who use escharotics and caustics to displace a pim- 
ple on the face, calling it a cancer, and use the inspissated juice, as an 
alterative, and in a plaster to the part, to blunt the Virulence of the caustic 
application. 

Datura Stramonium, — Jamestown weed, is a narcotic of much activity. 
This is also an ingredient in the bone ointment, and indispensable. I 
use the inspissated juice more than any other narcotic, opium excepted. I 
administer it in pills the bulk of one half kernel of wheat, or enough to 
slightly dilate the pupils, preferably to any other narcotic in neuralgia. 

The leaves simmered in lard are excellent in piles, boiled in water ap- 
plied in a fluid state, or in the form of cataplasm to painful tumors, or 
phlegmons will usually assuage pain; a tincture of the seeds, or leaves 
is used as a substitute for the inspissation. 

HyOSCyamus Niger, — Black Henbane. This is a naturalized plant, and 
much used as a narcotic ; the infusion, tincture, and extract are all in re- 
pute for the relief of painful and obstinate inflammations ; the internal 
use of this article, as well as stramonium will promptly allay irritation, 
and is preferable to opium in costive habits, as it does not constipate the 
bowels ; in large doses it occasions a disagreeable dryness in the mouth, 
and fauces, 
46 



358. Original Communications. [August, 

Cannabis Sativa, — Hemp. This is an ingredient in the ointment 
of which a recipe follows. It is proper to state that this is a naturalized 
plant sensibly narcotic, and the seeds contain a mucilage. It is a plant 
of some activity, belonging to the Dicecious Class, and may be employed 
with advantage externally in painful affections. 

In treating of narcotics, I omit Digitalis Purpurea, Conium, and seve- 
ral others, intending to describe those used in the ointment I have men- 
tioned, which is principally composed of narcotic and mucilaginous vege- 
tables, with a few vulneraries. 

MUCILAGES. 

Some of our vegetables contain a greater quantity of mucilage in the 
same bulk, or weight than others ; but the medical virtues of all pure 
mucilages is the same ; internally they blunt the acrimony of humors, lu- 
bricate the mouth and fauces, and prevent friction in the act of cough- 
ing. Externally they soothe the anguish of cutaneous eruptions, also in 
denuded surfaces, where inflammation succeeds vesication, scalds, burns, 
&c. They are useful in most of the diseases of the renal, and